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 |
427 | Seventeenth April 1868 10 1/2 Portland Street |
Robert Fiveash | Male | 64 years | Print Colorer |
Pthisis Pulmonalis 6 months Certified |
E. Fiveash Present at Death 10 1/2 Portland Street Walworth |
Seventeenth April 1868 | Fracis Thornton Registrar |