Literal question
To the Occupier</p>
<p>You are requested to insert the particulars specified on the other side, in compliance with an Act passed during the last Session of Parliament, and which received the Royal assent on the 7th September 1880</p>
<p>List of the members of this family, of visitors, of boarders, and of servants, who slept or abode in this dwelling on the night of Sunday, April 3rd, 1881</p>
<p><svar a="all" v="GB81B426"><br />8. Deaf-and-Dumb, Blind, Imbecile or Idiot, Lunatic.<br /><div class="i1">Write the respective Infirmities opposite the name of the afflicted Person; and if so from Birth, add "from Birth."<br /><br />[] Deaf-and-Dumb<br />[] Blind<br />[] Imbecile or Idiot<br />[] Lunatic<br />[] from Birth</div><br /></svar>