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Mother of how many children |
Place of birth |
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Whether able to speak English; or, if not, give language spoken |
Trade of profession of, or particular kind of work done by this person. |
General nature of industry, business, or establishment in which this person works. |
Whether an employer, employee, or working on own account |
If an employee- |
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Street, Avenue, Road, etc. |
House number or farm |
Dwelling Number |
Family number |
Surname |
Given |
Relation-ship of this person to the head of the family. |
Sex |
Color or Race |
Age at last birthday |
Whether single, married, widowed, or divorced |
Number of years at present marriage |
Number born |
Number living now |
of this person |
of Father of this person |
of Mother of this person |
Year of immigration to the U.S. |
Whether naturalized or Alien |
Whether out of work on April 15, 1910 |
Number of week out of work during 1909 |
Able to read |
Able to write |
Attended school any time since Sept. 1, 1909 |
Owned or Rented |
Owned free or mortgaged |
Farm or house |
Number of farm schedule |
Whether a survivor of the Union or Confederate Army or Navy |
Whether blind (both eyes) |
Whether deaf and dumb |
