| City | Hermoupolis |
|---|---|
| Year | 1876 |
| Fullname of Deceased | Ατζάλης Ιωάννης |
| Father's Name of Deceased | Νικόλαος |
| Mother's Name of Deceased | Μαρουσώ |
| Age of Deceased | 01 |
| Disease | Διάρροια |
| Date of death | 1876 11 03 4μμ |
| Date Registered | 1876 11 04 |
| Origin of Deceased | Χίος |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | Βρ.* |
| Record Number | 551 |
| Comments | Μάρτυς |
| Fullname Registrar | Γιωργαλάς Νικόλαος |
|---|---|
| Age Registrar | 38 |
| Country Registrar | Χίος |
| Occupation Registrar | Κηπουρός |
| Relation | Φίλος |