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 |
9 | May Sec??? 9h AM (?) Gledfield |
D David | Male | 82 years | Game ??? |
Old Age [Rest illegible] Certified [Illegible] |
[Illegible] |
1855 May 2 | [Illegible] |