| City | Hermoupolis |
|---|---|
| Year | 1894 |
| Fullname of Deceased | Γρίσπος Θεοφάνης Στ. |
| Father's Name of Deceased | Σταύρος |
| Mother's Name of Deceased | (not set) |
| Age of Deceased | 20 |
| Disease | Πνευμονική φθίσις |
| Date of death | 1894 11 28 11πμ |
| Date Registered | 1894 11 28 |
| Origin of Deceased | Αμοργός |
| Occupation of Deceased | Μουσικός |
| Marital Status of Deceased | Α |
| Record Number | 505 |
| Comments | Νοσοκομείο* |
| Fullname Registrar | Βαλσαμάκης Απόστολος |
|---|---|
| Age Registrar | 60 |
| Country Registrar | Ερμ |
| Occupation Registrar | Υπηρέτης Νοσοκ.* |
| Relation | (not set) |