| City | Hermoupolis |
|---|---|
| Year | 1895 |
| Fullname of Deceased | Μπουλούκου Ειρήνη |
| Father's Name of Deceased | Συμεών |
| Mother's Name of Deceased | Ευαγγελινή Μιχ. Τίγκα |
| Age of Deceased | 02 έ 06 μ |
| Disease | Ιλαρώδης βρογχοπνευμονία |
| Date of death | 1895 03 29 9μμ |
| Date Registered | 1895 03 30 |
| Origin of Deceased | (not set) |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | Βρ* |
| Record Number | 210 |
| Comments | (not set) |
| Fullname Registrar | Μπουλούκος Συμεών |
|---|---|
| Age Registrar | 45 |
| Country Registrar | Τήνος |
| Occupation Registrar | Λιθοξόος |
| Relation | Πατήρ |