| No. in Admissions Register: | 362 |
| Date of admission: | 28 August 1867 |
| Whence received: | Warwick Gaol |
| By whom brought: | - |
| On what terms: | - |
| Friends interested in him: | - |
| Description: | |
| Height: | 4 ft 5 ins |
| Figure: | Slender |
| Complexion: | Fair |
| Hair colour: | Brown |
| Eyes colour: | Dark brown |
| Perfect vision? | Yes |
| State of health: | Good |
| Able-bodied? | Yes |
| Sound intellect? | Yes |
| Use of all limbs? | Yes |
| Had cow or small pox? | Cowpox |
| Particular marks: | White spots on sides |
| Cutaneous disorder? | No |
| Scrofulous or consumptive? | No |
| Subject to fits? | No |
| Age last birthday: | 12 |
| Illegitimate? | - |
| Birthday: | - |
| Birth place: | - |
| Has resided: | 1 Brewery Street, Birmingham |
| Parish he belongs to: | - |
| Customary work and mode of life: | - |
| Schools attended: | - |
| By whom and where employed: | - |
| State of education: | |
| Reads: | Not at all |
| Writes: | Not at all |
| Cyphers: | - |
| General ability: | - |
| Offence: | Stealing gooseberries |
| Circumstances which may have led to it: | - |
| Date of sentence: | 7 August 1867 |
| Where convicted: | Aston |
| Who prosecuted: | - |
| Where imprisoned: | - |
| Sentence: | 21 days prison, 5 years at Saltley |
| Previous committals and convictions: | Stealing glass (14 days) |
| Father's name: | John Bonser |
| Occupation: | Labourer |
| Residence: | 26 Bewery Street, Great Lister Street, Birmingham |
| Mother's name: | Eliza Bonser |
| Occupation: | Marine store dealer |
| Residence: | - |
| Father's character: | Bad. Convicted of felony |
| Mother's character: | Bad. Convicted of felony |
| Parents dead? | - |
| Survivor married again? | - |
| Parents' treatment of child: | |
| Character of parents | Bad |
| Parents' wages: | - |
| Amount parents agree to pay: | 1s a week |
| Superintendent of police (to collect payments): | - |
| Relatives to communicate with: | - |
| Person making this return: | - |
| Estimate of character on admission: | - |
| Character on discharge: | - |
| When and how left the Reformatory: | - |
Notes: