EXTRACT OF AN ENTRY IN A REGISTER OF DEATHS
The Registration of Births, Deaths and Marriages (Scotland) Act 1965.
DESCRIPTION OF THE DECEASED PARTICULARS OF DEATH
No. | Sex. | Age. | Where born, and how long in this District | Parents' Names and Rank, Profession, or Occupation | To whom married | Issue, in Order of Birth, their Names and Ages. | When died. Year, Day of Month, Hour. | Where died. | Cause of Death, and how long Disease continued. Medical Attendant by whom certified, and when he last saw deceased. | Burial Place. Undertaker by whom certified. | Signature of Informant. | When and where registered. and Signature of Registrar. |
Male | 66 | Inveresk | John Archibald | Agnes Archibald | 1. Robert 45 | 1855 May | 19 Charles Street | Black Expectoration & | Grange Cemetery | (signed) | 1855 May 17th | |
years | Co. Edinburgh | Farm Servant | 2. John 43 | Fifteenth | Edinburgh | Colliers with Cavities | Edinburgh | Thomas Archibald | At Edinburgh | |||
3. Thomas 42
4. Christian 40 |
9h. 45m. P.M. | in Lungs | As Certified by | Son | ||||||||
10 years | 5. Elizabeth dec. at 10ms.
6. Agnes dec. 7 |
Many years | James McKean | (signed) | ||||||||
7. James dec.
4 1/2 8. James dec. 20m |
As Certified by | Undertaker | Thomas Herlot | |||||||||
9. Janet 27
10. Mary 25 |
John Biven M.D. | Registrar | ||||||||||
11. Henry dec. 8ms.
12. Agnes 22 |
who saw Deceased | |||||||||||
13. William 20 | May 14th 1855 |
Register of Deaths, for the District of the Castle and
Portsburgh, in the City of Edinburgh
this 18th day of September 1979.
ACTUAL IMAGE OF REGISTER EXTRACT: