Form used beetween 1899 and 1903
Date (or Port) of Embarkation Names of Passengers Adults Age Male Female Children between 1 and 14 Age Male Female Number of infants not over 1 year Passengers who are heads of families on board No. of persons belonging to the family Adults Children under 14 Passengers not belonging to any family on board Profession, Occupation or Calling of Passengers Nation or Country of Birth Births at Sea Deaths Places of ultimate destination of passengers, excepting "Tourists" and
"Returning Canadians" who are to be so described