| Description | Number, Name and [full] address, Drugs [administered], Age and religion, Date of admission, Date of discharge, Para and maturity [No of weeks pregnant], Ante-natal treatment [booked/not booked], Presentation and position, Onset of pains [date], Rupture of membranes [time], Child born [date], Placenta delivered [time], Perineum [intact/episiotomy], Operation [details], Anaesthetic [details], Attendants at birth: midwife/pupil/doctor [names], Sex [of child], Weight [of child], Remarks, Abnormalities: pains/labour/puerperium |