| No. in Admissions Register: | 201 |
| Date of admission: | 9 Jan 1861 |
| Whence received: | Stafford Gaol |
| By whom brought: | - |
| On what terms: | - |
| Friends interested in him: | |
| Description: | |
| Height: | - |
| Figure: | - |
| Complexion: | Fair |
| Hair colour: | Light |
| Eyes colour: | Blue |
| Perfect vision? | Yes |
| State of health: | Good |
| Able-bodied? | Yes |
| Sound intellect? | Yes |
| Use of all limbs? | Yes |
| Had cow or small pox? | Cowpox |
| Particular marks: | None |
| Cutaneous disorder? | No |
| Scrofulous or consumptive? | No |
| Subject to fits? | No |
| Age last birthday: | 12 |
| Illegitimate? | No |
| Birthday: | - |
| Birth place: | - |
| Has resided: | At the Lye Waste, Kingswinford |
| Parish he belongs to: | Kingswinford |
| Customary work and mode of life: | None |
| Schools attended: | None |
| By whom and where employed: | |
| State of education: | |
| Reads: | Not at all |
| Writes: | Not at all |
| Cyphers: | - |
| General ability: | - |
| Offence: | Stealing a tea cake at Brierley Hill |
| Circumstances which may have led to it: | Neglect of mother |
| Date of sentence: | 17 Dec 1860 |
| Where convicted: | Brierley Hill |
| Where imprisoned: | Stafford |
| Sentence: | 14 days prison, 5 years at Saltley |
| Previous committals and convictions: | None |
| Father's name: | - |
| Occupation: | - |
| Residence: | - |
| Mother's name: | - |
| Occupation: | - |
| Residence: | At the Lye Waste, Kingswinford |
| Father's character: | - |
| Mother's character: | - |
| Parents dead? | Father |
| Survivor married again? | No |
| Parents' treatment of child: | Much neglected by mother |
| Character of parents | - |
| Parents' wages: | Little or nothing |
| Amount parents agree to pay: | None |
| Superintendent of police (to collect payments): | W Mills, Superintendent of Police, Brierley Hill |
| Relatives to communicate with: | - |
| Person making this return: | W Mills, Police Officer, Brierley Hill |
| Estimate of character on admission: | - |
| Character on discharge: | - |
| When and how left the Reformatory: | - |
[Named as George Bolifer in the Admissions Register]
10 Dec 1862 Ill of whooping cough
14 Nov 1864 Licensed to work for Joseph Cookson, Mr H E Critchley, Sheffield Works, Coventry Road
Aug 1867 Called at the tailor's, doing respectably
Jan 1868 Called at the school, honest but rather poor
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