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 |
57 | December 6th: Ratcliff |
Mary Miller | Female | 76 years | Widow |
F???? |
her x mark Margaret Wiser Daughter Present at Death Ratcliffe |
Decr 12th | John ?a??? Registrar |