Form used between 1890 and 1894
Port of Embarkation LIVERPOOL No. of Ticket Names of passengers Adults Children Infants 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