| City | Hermoupolis |
|---|---|
| Year | 1876 |
| Fullname of Deceased | Μπαλάσου Αθανασούλα |
| Father's Name of Deceased | (not set) |
| Mother's Name of Deceased | (not set) |
| Age of Deceased | 80 |
| Disease | Νόσος χρ. |
| Date of death | 1876 11 03 4μμ |
| Date Registered | 1876 11 04 |
| Origin of Deceased | Πόρος |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | Χ [Θ] |
| Record Number | 550 |
| Comments | Μάρτυς |
| Fullname Registrar | Αρκουλής Ιωάννης |
|---|---|
| Age Registrar | 36 |
| Country Registrar | Ερμ |
| Occupation Registrar | Βυρσοδέψης |
| Relation | Φίλος |