| City | Hermoupolis |
|---|---|
| Year | 1876 |
| Fullname of Deceased | Καλπάκης Θεόδωρος |
| Father's Name of Deceased | Ματθαίος |
| Mother's Name of Deceased | Βασιλική Σολωμού |
| Age of Deceased | 18 μην |
| Disease | Λαρυγγίτις |
| Date of death | 1876 09 03 8μμ |
| Date Registered | 1876 09 04 |
| Origin of Deceased | Ερμ |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | Βρ.* |
| Record Number | 465 |
| Comments | Μάρτυς |
| Fullname Registrar | Καλπάκης Ματθαίος |
|---|---|
| Age Registrar | 35 |
| Country Registrar | Τήνος |
| Occupation Registrar | Λιθοξόος |
| Relation | Πατήρ |