JB/119/167/001

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Panopticon Bill. Forms
Friendly Guardian.

[F.1.]

Guardian's previous Examination

Examination of F.G. under the Statute of 34. Geo: 3. ch. SS in
quality of Friendly Guardian to A.P. Penitentiary Man [or A.M. Metasylum
man]

Place & Date

Bet it remembered that on this day came before me A.J. one of this Majesty's
Justices of the Peace for came F.G. of [Place] [Occupation] and
declared as follows, viz:

1. That there is now under confinement in the General Panopticon Penitentiary House as
Penitentiary Man one A.P.: and that the term of the said A.P. will expire on the
of Month next [or if in the Metasylum or serving according to any of the other]
opinions, state accordingly.

2. That the said A.P. is desirous of being on the day of his said enlargement committed
to the friendly care of the said F.G. on quality of a Ward under the said Statute.

3. That he the said F.G. hath accordingly consented and is desirous to take charge of the
said A.P. in quality of his Friendly Guardian.

4. That the said A.P. hath expressed himself desirous of repairing under such
Guardianship to [Place] there to exercise the occupation of [ ] and that
the said F.G. is willing and ready to assist him in so doing.

5. That, forasmuch as under the said Statute it is necessary that every such Friendly
Guardian should give a Bond under the penalty of £50 for the performance of
divers undertakings therein mentioned and should moreover pass examination in manner
hereafter following, thereby to justify as able to bear the penalty of such Bond
and as being in all other respects a fit person to be intrusted in the capacity aforesaid, he
the said F.G. is desirous to undergo such examination accordingly.

6. Whereas at the request of the said F.G. I have proceeded to take such his examination
which is as follows.

Examination.

1. Name

1. Being examined touching his name, the Examinant saith that it is F.G. as aforesaid:
that he hath always gone by the said name, and never by any other. Or if
there hath been any assumption of a new name state it: if according to Law sate the
manner

Identifier: | JB/119/167/001 "JB/" can not be assigned to a declared number type with value 119.
Date_1		Marginal Summary Numbering	not numbered
Box	119	Main Headings	panopticon
Folio number	167	Info in main headings field	panopticon bill
Image	001	Titles
Category	copy/fair copy sheet	Number of Pages	4
Recto/Verso	recto	Page Numbering	d1 f1 / d2 f2 / d3 f3 / d4 f4
Penner		Watermarks
Marginals		Paper Producer
Corrections		Paper Produced in Year
Notes public		ID Number	39678
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