| City | Hermoupolis |
|---|---|
| Year | 1877 |
| Fullname of Deceased | Ματασούμη Ελένη |
| Father's Name of Deceased | Αντώνιος |
| Mother's Name of Deceased | Ειρήνη Κατρή |
| Age of Deceased | 06 |
| Disease | ; |
| Date of death | 1877 08 13 4μμ |
| Date Registered | 1877 08 14 |
| Origin of Deceased | Ερμ |
| Occupation of Deceased | (not set) |
| Marital Status of Deceased | (not set) |
| Record Number | 446 |
| Comments | Μάρτυρες |
| Fullname Registrar | Ματασούμης Αντώνιος |
|---|---|
| Age Registrar | 40 |
| Country Registrar | Λέρος |
| Occupation Registrar | Βαστάζος |
| Relation | Πατήρ |