CONVICT LABOK FOR IIOAD VVOKK. 



53 



Form No. 4.1. 



CONVICT ROAD FORCE. 



(Name of County or State.) 



PRISONERS' TIME SHEET. 



Camp No. 



Place, 



Month of , 191. . 



Signature, , Supt. 



Prison 

 No. 



Name. 



Days on 

 road. 



Days 

 camp 

 duty. 



Days 



bad 



weather. 



Days of 

 sickness. 



Days, 

 Sundays 

 and holi- 

 days. 



Total 



number 



days. 



















Tot£ 



1 carried forward 

























Form No. 4.2. 



FORM 10. SIZE, 8 BY W, INCHES. 

 , CONVICT ROAD FORCE. 



Camp No. 



(Name of County or State.) 



MOVEMENT OF PRISONERS. 



Place, Month of . 



Signature, 



.,191.. 



., Supt 



On hand first day of month 



Received during month 



Recaptured and returned during month. . 



To be accounted for 



Discharged 



Pardoned or paroled 



Died 



Escaped during month, and still at large . 

 Sent to 



Convicts on hand at end of month 



Total (should agree with total above) . 

 Remarks: 



FORM 11. SIZE, 8 BY lOi INCHES. 



Form No. 4.3. 



Number of camp. 

 Place 



( Name of County or Stale.) 



CONVICT ROAD FORCE. 



DAILY REPORT OF SICKNESS. 



Date of Illness 



Day of illness (as 1st, 2d, 3d, etc.; 



Name of convict 



Of what does the convict complain? 



What signs of sickness did he show to-day V 



Wiiat treatment was given to-day? 



Wa.s he seen by the doctor to-day? 



Doctor's diagnosia to-day 



Signature of superintendent . 



FORM 12. SIZE, 8 By lOJ INCHES. 



