Formulaire utlisé entre 1882 et 1889
(Disponible en anglais seulement)
Port of Embarkation
No. of Contract Ticket
Names of Passengers
Profession, Occupation, or Calling of Passengers
English
Age of each Adult of 12 years and upwards
Married
Male
Female
Single
Male
Female
Ages of Children between 1 and 12 years
Male
Female
Infants
Male
Female
Scotch
Age of each Adult of 12 years and upwards
Married
Male
Female
Single
Male
Female
Ages of Children between 1 and 12 years
Male
Female
Infants
Male
Female
Irish
Age of each Adult of 12 years and upwards
Married
Male
Female
Single
Male
Female
Ages of Children between 1 and 12 years
Male
Female
Infants
Male
Female
Foreigners
Age of each Adult of 12 years and upwards
Married
Male
Female
Single
Male
Female
Ages of Children between 1 and 12 years
Male
Female
Infants
Male
Female
Port at which Passengers have contracted to Land