| City | Hermoupolis |
|---|---|
| Year | 1876 |
| Fullname of Deceased | Μπολέτου Αναστασία |
| Father's Name of Deceased | (not set) |
| Mother's Name of Deceased | (not set) |
| Age of Deceased | 75 |
| Disease | Γήρας |
| Date of death | 1876 05 13 4μμ |
| Date Registered | 1876 05 14 |
| Origin of Deceased | Κυδωνίαι |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | Χ [Θ] |
| Record Number | 250 |
| Comments | Μάρτυρες |
| Fullname Registrar | Βάρβης Μιχαήλ |
|---|---|
| Age Registrar | 35 |
| Country Registrar | Ιος |
| Occupation Registrar | Οπωροπώλης |
| Relation | Συγγενής |