| Page No | 24 |
| Entry No. | 191 |
| Baptism Date | 23rd Sept 1875 |
| Christian Name | Henry Thomas, son of |
| Father | William John |
| Mother | Lucy |
| Surname | Burgess |
| Abode | Drayton |
| Quality, Trade or Profession | Labourer |
| Ceremony Performed By | Edward Tew Richards, Rector |
| Note | Written in margin " Privately Baptised" |