THIRTEENTH CENSUS OF THE UNITED STATE: 1910 -- POPULATION

[State] [County] [Supervisors District] [Enumeration District] [Township] [Enumerated by me on the] [day of] 
[, 1920] {signed} [Enumerator.]

[farm/dwelling visited] [family visited]

[Name] [Relation] [Sex] [Race] [Age] [Marital Status] [Length of Present Marriage] [Birthplace] [Father's 
Birthplace] [Mother's Birthplace] [Language Spoken] [occuation] [industry] [class of worker] [able to read] 
[able to write] [own or rent home] [owned free or mortgaged] [farm or home] [number on farm schedule] 
[survivor of the Union or Confederate Army or Navy] [Blind] [Deaf & Dumb]

[Name] [Relation] [Sex] [Race] [Age] [Marital Status] [Lengh of Present Marraige] [Number of children 
born]  [Number of children living] [Birthplace] [Father's Birthplace] [Mother's Birthplace] [Language 
Spoken] [Occupation] [Able to read] [Able to write] 

[Name] [Relation] [Sex] [Race] [Age] [Marital Status] [Birthplace] [Father's Birthplace] [Mother's 
Birthplace] [Language Spoken] [Occupation] [Able to read] [Able to write] [attended school since 9/09] 

[Name] [Relation] [Sex] [Race] [Age] [Marital Status] [Birthplace] [Father's Birthplace] [Mother's 
Birthplace] [Language Spoken] [Occupation] [attended school since 9/09]