(Section 117)
POLL BOOK
/ ..........
Voter’s number / No
/ .............................................
Name of voter /
Poll Book
. . ..
. . Occupation ..
..............................................................
. . ..
. . Address ..
..............................................................
. . ..
. . Ballots not bearing the initials ..
. . of the deputy returning officer ..
..............................................................
. . ..
. . Objections ..
..............................................................
. . ..
. . Oath ..
. . ..
..............................................................
. . ..
. . Refusal to take oath ..
. . ..
..............................................................
. . ..
. . Votes given ..
..............................................................
. . ..
. . Ballots ..
. . spoiled or cancelled ..
..............................................................
. . ..
. . Voted after another ..
. . voted in his name ..
..............................................................
. . ..
. . Voted with written ..
. . authorization of returning officer ..
..............................................................
. . ..
. . Ballot prepared ..
. . with assistance ..
..............................................................
. . ..
. . Remarks ..
. . ..