Death of Robert Fiveash


REGISTRATION DISTRICT CAMBERWELL
1909 DEATH in the Sub-district of Camberwell South in the County of London

No When and where died Name and surname Sex Age Occupation Cause of death Signature, description and residence of informant When registered Signature of Registrar
113 Ninth June 1909
Southwark Infirmary		 Robert Fiveash Male 81 years General Laborer
15 Cancel Street 		Emphysema
Ch. Bronchitis
Heart Failure
Certified
M. M. Adams L.R.C.P.
E. Gallini
Niece
15 Cancel Street, Walworth
 Tenth June 1909 W. L. Churchill Registrar
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