00NV1CT LABOR FOR ROAD WORK. 
53 
Form No. 4.1. 
Camp No. 
CONVICT ROAD FORCE. 
( Name of County or State . ) 
PRISONERS' TIME SHEET. 
Place, Month of , 191. . 
Signature, , Supt. 
Prison 
No. 
Naftie. 
Days on 
road. 
Days 
camp 
duty. 
Days 
bad 
weather. 
Days of 
sickness. 
Days, 
Sundays 
and holi- 
days. 
Total 
number 
days. 
Totr 
1 carried forward 
I 
1 
Form No. 4.2. 
FORM 10. SIZE, 8 BY 10| 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 10| INCHES. 
Form No. 4.3. 
Number of camp. 
(Name of County or State.) 
CONVICT ROAD FORCE. 
DAILY REPORT OF SICKNESS. 
Place 
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? 
What treatment was given to-day? 
Was he seen by the doctor to-day? 
Doctor's diagnosis to-day 
Signature of superintendent . 
FORM 12. SIZE, 8 By 10* INCHES. 
