| Sub Registration | Hayes |
| Civil Parish | Norwood |
| County | Middlesex |
| Address | 57 Beaconsfield Road, Southall |
| Surname | First Name | Rel | Age | Sex | Marr | Years Marr | Born Live | Living | Died | Occ | Industry | Employ Status | Work at Home | Birthplace | Nationality |
| GREEN | Walter | Head | 35 | M | Married | 11 years | 1 | 1 | Inspector of Railway Company | MR | Wilts "Malmesbury" | ||||
| GREEN | Jane | Wife | 40 | F | Married | 11 years | 1 | 1 | Dublin | ||||||
| GREEN | Stanley | Son | 9 | M | School | Middlesex "Willesden" | |||||||||
| JEPSEN | Kristian | Boarder | 21 | M | Single | Dairyman | Southall | Worker | Denmark | Danish |
| Number of Rooms | 4 Rooms |
| Signature | Walter GREEN |
| Postal Address | 57 Beaconsfield Rd, Southall, Middlesex |
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