| City | Hermoupolis |
|---|---|
| Year | 1876 |
| Fullname of Deceased | Σουρής Κυριάκος |
| Father's Name of Deceased | Διαμαντής |
| Mother's Name of Deceased | Αικατερίνη Φούλη |
| Age of Deceased | 04 μην |
| Disease | Βρέφος; |
| Date of death | 1876 05 12 5μμ |
| Date Registered | 1876 05 13 |
| Origin of Deceased | Ερμ |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | Βρ.* |
| Record Number | 246 |
| Comments | Μάρτυς |
| Fullname Registrar | Διακογεωργίου Ιωάννης |
|---|---|
| Age Registrar | 36 |
| Country Registrar | Χίος |
| Occupation Registrar | Πετροκόπος |
| Relation | Συγγενής |