WANS 7 BOROUGH OF WANSTEAD AND WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1942. BOROUGH OF WANSTEAD AND WOODFORD Annual Report of the MEDICAL OFFICER OF HEALTH For the Year Ending 31st December, 1942. PUBLIC HEALTH STAFF. Medical Officer of Health (part time), R. F. Vere Hodge, M.D., Cantab. Senior Sanitary Inspector, H. C. Howard, M.R.San.I., M.S.I.A. (a) (c). Deputy Senior Sanitary Inspector, E. Jackson, M.R.San.I., M.S.I.A. (b) (c) (d). Sanitary Inspectors, A. J. Storer, M.S.I.A. (b). (Joined R.A.M.C., 28th May, 1940.) Health Visitors, Miss H. M. Hird, S.C.M. (e) Miss F. Smith, S.R.N., S.C.M. (e) (from 12th January, 1942). Midwives, Miss S. A. Jones, S.C.M. Mrs. M. Marlow, S.C.M. Miss I. Turner, S.C.M. Clerks, F. E. Farrington. (Joined R.A.D.C., 2nd May, 1940.) S. C. Hearson, Chief Clerk. Miss A. E. Harrison (from 23rd June, 1941). Mrs. M. Fotios (from 23rd March, 1942). (a) Royal Sanitary Institute Certificate for Sanitary Inspector. (b) Royal Sanitary Institute and Sanitary Inspector's Examination Joint Board Certificate. (c) Royal Sanitary Institute Certificate of Meat and other Foods. (d) Royal Sanitary Institute Certificate for Sanitary Science as applied to Buildings and Public Works. (e) Royal Sanitary Institute Certificate for Health Visitor. WANSTEAD AND WOODFORD BOROUGH COUNCIL ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the Year Ending 31st December, 1942. In the year under review the public health of the district remained satisfactory and the incidence of infectious disease approximately of the pre-war standard. The estimate of resident population 1942 as given by the registrarGeneral shows an increase of 3,200. The birth rate has increased by 4 per thousand and the death rate by 0.37 per thousand. Section A. Statistics and Social Conditions of the Area. Area (in acres) 3,824 Registrar-Generals estimate of resident population, 1942 49,850 Number of inhabited houses (end of 1942) according to Rate Books 16,000 Rateable value (end of 1942) £576,843 Sum represented by a penny rate (1942-1943) £2,222 Extracts from Vital Statistics of the Year. Live Births. Legitimate Males 384 Females 389 Total 773 Illegitimate Males 16 Females 14 Total 30 Total Males 400 Females 403 Total 803 Birth rate per 1,000 of the estimated resident population 16.1. 4 Stillbirths. Legitimate Males 9 Females 8 Total 17 Illegitimate Males 0 Females 0 Total 0 Total Males 9 Females 8 Total 17 Rate per 1,000 total (live and still) births — 20.73. Deaths. Males — 288. Females — 284. Total — 572. Crude Death rate per 1,000 of the estimated resident population—11.47. Adjusted Death Rate - 11.2. Deaths from puerperal causes: — Puerperal and post-abortion sepsis NIL Other maternal causes 1 Total 1 Rate per 1,000 total (live and still) births 1.2 Death Rate of Infants under one year of age: — All infants per 1,000 live births 26.15 Legitimate infants per 1,000 legitimate live births 25.87 Illegitimate infants per 1,000 illegitimate live births 33.3 Deaths from Cancer (all ages) 127 Deaths from Measles (all ages) NIL Deaths from Whooping Cough (all ages) 1 Deaths from Diarrhoea (under 2 years of age) 3 5 Birth-rates. Oivilian Death-rates, Analysis of Mortality, Maternal Mortality, and Case-rates for certain Infectious Diseases in the year 1942. England and Wales, London, 126 Great Towns and 148 Smaller Towns. (Provisional Figures based on Weekly and Quarterly Returns) England and Wales 126 County Boroughs and Great Towns including Londor. 148 Smaller Towns (Resident populations 25,000 to 50,000 at 1931 Census) London Administrative County Borough of WANSTEAD and WOODFORD Rates per 1,000 Civilian Population Births: Live 15.8 17.3 18.4 14.0 16.1 Still 0.54 0.66 0.62 0.48 0.34 Deaths : All Causes 11.6 13.3 12.1 13.9 11.47 Section B. General Provisions of Health Services for the Area. 1. (1) Public Health Officers of the Authority:— Particulars are given on page 2, at the beginning of this report. (2) (a) Laboratory facilities: All pathological and bacteriological services are provided by the Essex County Council. The facilities at the Essex Public Health Laboratory, 91 Queen Victoria Street, London, E.C.4, were available to the beginning of May, 1941, but, since then, Dr. Suckling's Emergency Laboratory, Gidea Park College, Gidea Park. Essex, has been used. The analysis of water, milk and food is carried out by Dr. Bernard Dyer and Mr. George Taylor, Public Analysts for the Borough. (b) Ambulance facilities:— (i) For infectious diseases. All cases requiring removal to hospital are conveyed by the ambulances attached to the hospitals. (ii) For non-infectious and accident cases. Cases of this class are taken to hospital by either of the two ambulances belonging to the Borough Council. A satisfactory service is maintained throughout the district. (c) Nursing in the home:— Home nursing is carried out:— (i) By private nurses; (ii) By district nurses working under a Committee and supported by voluntary contributions and receipts from patients. 6 (d) Clinics and Treatment Centres:— Child Welfare Centres. There are five centres in the district: — (i) St. Barnabas Church Hall, Snakes Lane. (ii) Fuller's Road Sunday School. (iii) Baptist Church Hall, Aldersbrook. (iv) Ashton Playing Fields Pavilion, Chigwell Road. These are supported and directed by the Borough Council. (v) Holy Trinity Church Hall, Hermon Hill. This is under the direction of a voluntary committee, but is subsidised by the Council. The following treatment centres in the district are under the control of the County Council:— (i) The Tuberculosis Dispensary. (ii) The School Clinic. (iii) The Orthopaedic Clinic. (Conjointly with the British Red Cross Society). (iv) The Mental Treatment Clinic. These all find accommodation at The Shrubberies, High Road, South Woodford. (e) Hospitals. Public and Voluntary:— Maternity. There are no maternity hospitals in the district. Our arrangements for the reception of maternity cases which we had before the war with Queen Mary's Hospital, Stratford, are no longer in operation. We are still able to send cases of Puerperal Pyrexia to the Waltham Joint Hospital, but for other cases where the condition of the mother or home conditions require that the mother should be removed, we have been making arrangements to evacuate the patients to hospitals outside the district. Children.—There is a children's ward of five beds at the Woodford Jubilee Hospital. Infectious Diseases.—Cases of infectious diseases in Wanstead and Woodford, which required removal, were taken to the Waltham Joint Hospital, under the control of the Waltham Joint Hospital Board. Since November, 1936, the Waltham Joint Hospital Board have been willing to admit, in addition to Scarlet Fever and Diphtheria, cases of the following diseases:— Complicated cases of Measles, Whooping Cough, Influenza and Pneumonia; The acute infectious diseases of the nervous system, Meningitis, Poliomyelitis and Encephalitis; Typhoid and Paratyphoid Fevers; Dysentery, Erysipelas and Ophthalmia Neonatorum; Puerperal Pyrexia. 7 Smallpox.— The London County Council are prepared to receive cases of Smallpox from this area into the London Smallpox Hospital so long as they have sufficient accommodation available. 2. Maternity and Child Welfare: — (1) Midwifery and Maternity Services.— No changes have been made in the personnel of the service. We have three Municipal Midwives working in the district. Except for ante-natal visiting they devote the whole of their time to midwifery. The number of cases attended by them was as follows: — (a) As Midwives 186 (b) As Maternity Nurses 30 Number of visits paid by these Midwives:— (a) Number of cases 216 (b) Ante-natal visits 1,918 (c) Nursing visits 3,380 Ante-natal Supervision.—This is given to all women attended by the Municipal Midwives and in every case one or more examinations are made and if necessary treatment is given by a doctor of the patient's choice. In necessitous cases the fees for the medical services are paid by the Council. In 1942 payments were made to medical practitioners in 12 cases. Cousultant.—Mr. Alan Brews, F.R.C.S., is the Consulting Obstetric Surgeon to the Borough. (2) Institutional Provision for Mothers or Children.—Over 50 per cent.—546 out of 850 — births in Wanstead and Woodford occurred in private nursing homes. 3. Health Visitors.—Miss F. Smith took up her appointment in January. The following particulars of the work done by the Health Visitors arttaken from Form M.C.W.96 (Revised), which was sent to the Ministry o( Health in advance of this report. Number of visits paid during the year by the Health Visitors: — (a) To children under one year of age:— First visits 693 Total visits 2,224 (b) To children between the ages of one and five years:— Total visits 3,080 Infant Welfare Centres.—The following attendances were recorded at the five Centres serving the Wanstead and Woodford residents: (a) Children under one year of age 28,575 (b) Children between the ages of one and five years 10,494 8 4. Child Life Protection.—The Health Visitors are appointed Child Life Protection Visitors under Part VII of the Public Health Act, 1936. There were eight foster-mothers and ten foster-children on the Register at the end of the year. A total of 101 visits were paid by the Visitors. 5. (a) Arrangements for Dental Cases.- Arrangements were made with the local dentists in 1937 to undertake the dental treatment of expectant and nursing mothers and children under school age. Their charges are on an agreed scale and the fees payable by the patients are assessed according to their means, on a scale similar to that of the Essex County Council. During the year 1942, three mothers and five children were treated under this Scheme. (b) Arrangements for Orthopaedic cases. There is an orthopaedic clinic at the Shrubberies, High Road, South Woodford, directed conjointly by the British Red Cross Society and the Essex County Council. Section C. Sanitary Circumstances of the Area. 1. (1) Water Supply.— The water service throughout the district is supplied by the Metropolitan Water Board. (2) Drainage and Sewerage.— There have been no important extensions of sewerage or improvements made in the arrangements for drainage, sewerage and sewage disposal. 2. Rivers and Streams.— The results of the analyses of samples of effluent from the three sewage works were satisfactory. 3. (1) Closet Accommodation.—With the exception of four isolated dwellings, house drainage throughout the district is conducted on the water carriage system. (2) Public Cleansing.— The collection and disposal of house refuse has continued to be carried out under contract requiring the maintenance of a weekly collection throughout the district and the disposal of the refuse under controlled tipping conditions, subject to prevailing salvage operations. Kitchen waste is collected and delivered to the County Borough of East Ham for processing for the purposes of animal food, in accordance with the Ministry of Supply direction. (3) Sanitary Inspection of the Area.—The Report of the Senior Sanitary Inspector is included at the end of this Section. (4) Shops and Offices.— Under the provisions of the Shops Acts, 1934, a total of fifty-two shop inspections were recorded. Improvements with regard to ventilation and temperature of shops and to sanitary conveniences were effected upon two premises. 9 Shops (Hours of Closing) Act, 1928. Under the provisions of Defence Regulations, 1939, earlier closing hours operated during the winter months and normal closing hours were resumed between March and November. It was unnecessary to warn shopkeepers against any contraventions. (5) Eradication of Bed Bugs. The means employed for eradication of the bed bug as outlined in previous reports has been continued with satisfactory results. The number of premises disinfested was six; no Council owned houses were disinfested. The insecticides used were Pyagra and Deodex preparations. Spraying and steam disinfestation is carried out by the staff of the Public Health Department. 4. Schools.— One Public School, one Secondary School and eight Elementary Schools are situated in the district. There are several private schools With the exception of one private school all schools were open during the year. The sanitary condition and water supply remained satisfactory. SANITARY INSPECTION OF THE AREA. Report of the Senior Sanitary Inspector. In accordance with Article 27(18) of the Sanitary Officers' (Outside London) Regulations, 1935, I beg to submit the following particulars with regard to the work accomplished by the Sanitary Inspectors during the year 1942. Owing to war time conditions a considerable amount of time was taken up in connection with the following matters: Arrangements for the treatment and disposal of foodstuffs contaminated by gas. Civilian war deaths. Salvage operations. Arrangements to collect Kitchen Waste. Underground shelters. War damaged premises (drains and sanitary arrangements). Summary of the various inspections made by the Sanitary Inspectors: — Du elling Houses On complaint and other causes 592 Infectious disease enquiries 93 Food poisoning enquiries 13 Premises measured for purposes of Part IV of the Housing Act, 1936 (abatement of overcrowding) 3 Number of rooms measured in these premises 12 Rent Restriction Act enquiries Total number of re-inspections for all purposes 1,280 10 Other Premises— Schools 28 Factories 77 Meat distributing centre 298 Butchers' shops and provisions stores 271 Bakehouses 27 Fishshops 83 Dairies and Milkshops 43 Massage Establishments 11 Other Food premises 101 Rat infestations 194 Verminous premises 6 Petroleum installations 102 Shops Act 52 Premises where animals are kept 35 Miscellaneous inspections, including visits due to war circumstances 546 Total number of inspections and re-inspections 3,223 Drainage— Renewed or repaired, including war damaged drains . . 65 Notices served— Informal: — Housing Act, 1936 20 Public Health Acts 130 , Statutory: — Public Health Act, 1936, Section 24 6 „ 39 3 „ 45 2 „ 93 3 Housing Act, 1936, Section 9 6 Factories Act, 1937.—The total number of factories registered at the close of the year was (1) Power Factories—80, (2) Non-power factories—46. These included fourteen bakehouses, two being underground bakehouses. Informal notices were served and satisfactory results obtained in respect of 4 factories with regard to cleanliness of premises, improvement or repair to sanitary arrangements, as well as improved ventilation. Rent and Mortgage Interest Restrictions Acts, 1920 to 1939.—A few enquiries were made by occupiers of premises with regard to their position under the Act, but notices served in respect of the conditions referred to usually had the desired effect. No certificates were granted. 11 Rats and Mice (Destruction) Act, 1919.—One hundred and ninety-four visits were paid to premises in connection with complaints received and in the majority of cases the source of rat infestation was definitely traced, the premises being freed of rats with the aid of a Cyanogas foot pump wherever this could be applied safely, or by means of Red Squill baits. Factories and Food Premises were also kept under supervision for rat infestation, and methods for their extermination were adopted in necessary cases. Petroleum (Regulation) Acts, 1928 and 1936.—A total of fifty-two licences were renewed at the beginning of the year and included two licences for the storage of cellulose. In addition, two other licences were granted for the storage of petroleum mixture. The total storage capacity under licences amounted to 74,180 gallons for petroleum, 100 gallons cellulose, and 100 gallons rubber solution. Game Licences.—Seven of the eight licences to deal in game were renewed, and one new licence was issued during the year. Section D. Housing. No houses were erected during 1942. 1. Inspection of Dwelling-houses during the Year:— (1) (a) Total number of dwelling houses inspected for housing defects (under Public Health or Housing Acts) 592 (b) Number of inspections made for the purpose 1,872 (2) (a) Number of dwelling-houses (included under subhead (1) above) which were inspected and recorded under the Housing Consolidated Regulations, 1925 and 1932 Nil (b) Number of inspections made for the purpose Nil (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation Nil (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-head) found not to be in all respects reasonably fit for human habitation 159 2. Remedy of Defects during the Year without Service of formal Notices: — Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 150 3. Action under Statutory Powers during the Year: — (a) Proceedings under sections 9, 10 and 16 of the Housing Act. 1936: 12 (1) Number of dwelling-houses in respect of which notices were served requiring repairs 6 (2) Number of dwelling-houses which were rendered fit after service of formal notices: (a) By owners 3 (b) By Local Authority in default of owners Nil (6) Proceedings under Public Health Acts:— (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 20 (2) Number of dwelling-houses in which defects were remedied after service of formal notices: (a) By owners 3 (b) By Local Authority in default of owners 7 (c) Proceedings under sections 11 and 13 of the Housing Act, 1936: — (1) Number of dwelling-houses in respect of which Demolition Orders were made Nil (2) Number of dwelling-houses demolished in pursuance of Demolition Orders Nil 4. Housing Act, 1936.—Part IV.—Overcrowding:— (a)(1) Number of dwellings overcrowded at the end of the year 13 (2) Number of families dwelling therein 13 (3) Number of persons dwelling therein 85 (b) Number of new cases of overcrowding reported during the year Nil (c) (1) Number of cases of overcrowding relieved during the year Nil (2) Number of persons concerned in such cases Nil (d) Particulars of any cases in which dwelling-houses have again become overcrowded after the Local Authority have taken steps for the abatement of overcrowding Nil (e) Any other particulars with respect to overcrowding conditions upon which the Medical Officer of Health may consider it desirable to report Nil 13 FACTORY AND WORKSHOP ACT, 1901, AND THE FACTORIES ACT, 1937. 1. Inspections for the purposes of provisions as to health. Including Inspections made by Sanitary Inspectors. Premises Number of Inspections. Written Notices. Occupiers Prosecuted. Factories with mechanical power 29 ... ... Factories without mechanical power 40 ... ... Other premises (other than Outworkers' premises) 8 ... ... Total 77 ... ... 2. Defects found. Particulars. Number of Defects. Number of defects in respect of which Prosecutions were instituted. Pound. Remedied. Referred to H.M. Inspector. Want of Cleanliness ... ... ... ... Overcrowding ... ... ... ... Unreasonable temperature ... ... ... ... Inadequate Ventilation 2 2 ... ... Ineffective drainage of floors ... ... ... ... Sanitary Conveniences:— 1. Insufficient 1 1 ... ... 2. Unsuitable or defective 3 3 ... ... 3. Not separate for sexes ... ... ... ... Other Offences ... ... ... ... Total 6 6 ... ... 14 Section E. Inspection and Supervision of Food. (a) Milk Supply.- Milk is not produced within the district for the purpose of sale. The number of persons and premises registered tor the sale of milk within the district are as follows:— Premises registered as Dairies and Milkshops 17 Persons registered as retail purveyors of milk in sealed bottles 15 Persons registered as retail purveyors of milk whose premises are situated outside the district 20 Number of inspections 43 The premises concerned were generally well maintained; minor infringements of the Regulations were abated promptly. "Designated" Milk.- The number of licences granted for the sale of designated milk under the Milk (Special Designations) Order, 1936, are as follows: — Designation. Licences Supplementary Licences. Tuberculin Tested 7 4 Accredited ... 1 Pasteurised 12 6 (b) Food and Drugs Act. 1938.—Twenty samples of food, including four samples of milk were obtained for analysis. All of the samples were reported by the Public Analyst as being genuine. (c) Meat and Other Foods.—The Government meat distributing depot was under constant supervision during the year, and a total of 298 inspections were made. The total quantity of meat, including offal, condemned as unfit for human consumption amounted to one ton, twelve hundredweights three quarters. Food examined upon other premises and surrendered as unfit for human consumption included the following:— 101 tins Luncheon Meat. 1 tin Brisket Beef. 53 tins Sausage Meat. 20 tins Chopped Ham. 15 15 tins Stewing Steak. 5 tins Lunch Tongue. 1 tin Meat Galantine. 16 tins Ready Meals. 2 tins Savoury Lunch. 5 tins Rabbit. 8 lbs. Lamb Trimmings. 25 jars Meat Paste. 30 tins Salmon. 91 tins Pilchards. 1 tin Fish Cake Roll. 20 tins Crawfish. 1 glass Herrings. 42 lbs. Kippers. 2 sacks Bread. 68 lbs. Cheese. 190 tins Evaporated Milk. 45 tins Condensed etc. Milk. 1 tin Cream. 51½ lbs. Haricot Beans. 77 lbs. Onions. 3 tins Vegetables in gravy. 29 tins Tomatoes. 81 tins Beans. 20 tins Peas. 1 tin Carrots. 20 tins Pineapple. 6 tins Apple. 2 tins Peach. 2 tins Pears. 1 tin Plums. 22 lbs. Prunes. 2 lbs. Mixed Dried Fruit. 1 tin Spaghetti. 12 tins Rice. 12 tins Soup. 28 Pkts. S. R. Flour. 14 Pkts. Custard Powder. 16 lbs. Pearl Barley. 80 lbs. Rolled Oats. 3 Pkts. Salt. 3 lbs. Biscuits. 3 lbs. Granulated Sugar. 5 pkts. Coffee. 15 x ¼lb. bars Chocolate. 10 x ½lb. jars Marmalade and Jam. Registration of Food Premises.—No additional certificates were granted under Section 34 of the Food and Drug Act, 1938, for the purpose of 16 carrying on the business of a wholesale dealer in margarine. Bakehouses.—There are fourteen bakehouses in the district; two of these are underground bakehouses. Twenty-seven inspections were made and the provisions of the Bakehouse Regulations were observed satisfactorily. Section F. Prevalence of, and Control over. Infectious and other Diseases. 1. (a) Scarlet Fever.- Seventy-nine cases were notified. No deaths occurred. (b) Diphtheria.- Three cases were notified. No deaths occurred. Diphtheria Immunisation.—The numbers of completed inoculations made during the year were:—Children under 5 years, 741; children over 5 years but under 15 years, 699. (c) Puerperal Pyrexia.—Twelve cases were notified, nine of these occurred in the district and were removed to the Waltham Joint Hospital, and the other three were notified from hospitals in the Metropolitan area. No deaths occurred. (d) Typhoid and Paratyphoid Fevers.- One case of paratyphoid was notified as occurring. (e) Dysentry.—Seven cases were notified. There were no deaths. (f) Cerebro-Spinal Fever.—Eight cases were notified as occuring in the district. Two were removed to the Waltham Joint Hospital and five to hospitals outside the district. (g) Encephalitis Lethargica.—One case was notified, and died in a hospital outside the district. Particulars of the incidence of notifiable diseases during 1942 are contained in an accompanying table. 2. (a) Disinfection and Disinfestation.—The disinfection of bedding and similar articles is done by the saturated steam process in a cylindrical horizontal steel " Thresh "disinfector; infected premises are sprayed with formalin and fumigated by burning formalin tablets. Number of rooms disinfected 170 Number of verminous rooms disinfected 22 Loads of bedding disinfected 196 Loads of bedding disinfected for Chigwell U.D.C. 4 Number of School classrooms disinfected 10 (c) Tuberculosis.—Public Health (Prevention of Tuberculosis) Regulations, 1925, and the Public Health Act, 1936, section 172. No 17 action was necessary with regard to persons suffering from pulmonary tuberculosis employed in the milk trade. 3. Tuberculosis.—Particulars of new cases of tuberculosis and mortality from the disease during 1942:— 42 Pulmonary and 21 non-Pulmonary cases were notified for the first time during the year. 9 cases were transferred into the district. 33 Pulmonary cases and 4 non-Pulmonary cases died during the year. 10 deaths occurred from non-notified cases of tuberculosis. 3 cases were restored to the register. 39 other cases were removed from the register. 232 cases remained on the register at the close of the year. County Tuberculosis Scheme.—Dr. W. A. Bullough, Chief Tuberculosis Officer of the Essex County Council, has kindly furnished me with the following particulars of Wanstead and Woodford patients sent to institutions for treatment during 1942:— Pulmonary. Non-Pulmonary. Total. M. F. M. F. Adults 26 8 2 6 42 Children 2 6 2 1 11 18 NOTIFICATION OF INFECTIOUS DISEASE. Small Pox Scarlet Fever Diphtheria Typhoid including Paratyphoid Erysipelas Tuberculosis Puerperal Pyrexia Ophthalmia Neonatorum Pneumonia Cerebro-spinal Fever Acute Poliomyelitis Measles Whooping Cough Other Diseases Pulmonary Other Forms 1938 0 83 35 l 24 37 22 11 4 39 0 2 3 1939 0 52 22 3 10 28 9 8 3 28 0 0 2 1940 0 24 8 1 13 24 7 7 1 31 12 0 95 4 4 1941 0 85 21 Typhoid 0 10 46 15 3 0 41 8 1 586 280 0 Paratyp'd 8 1942 0 81 3 1 11 42 21 12 2 31 7 0 523 176 9 19 VITAL STATISTICS OF WHOLE DISTRICT DURING PREVIOUS YEARS. Year. Population. Births. Deaths Infantile Mortality. Number. Rate. Number Rate Number. Rate per 1000 Births. 1938 54,810 744 13.6 521 9.5 23 30.9 1939 55,880 763 13.7 555 10.4 28 37.8 1940 48,620 611 12.6 653 13.4 18 31.8 1941 46,640 566 12.1 551 11.1 15 30.24 1942 49,850 803 16.1 572 11.47 21 26.15 MAYBANK PRESS, Printers, E.18.