| City | Hermoupolis |
|---|---|
| Year | 1876 |
| Fullname of Deceased | Γούτας Ιάκωβος Σπ. |
| Father's Name of Deceased | Σπύρος |
| Mother's Name of Deceased | Σοφία |
| Age of Deceased | 22 |
| Disease | Πνευμονία |
| Date of death | 1876 06 29 6μμ |
| Date Registered | 1876 06 30 |
| Origin of Deceased | Ερμ |
| Occupation of Deceased | Πλακουντοποιός |
| Marital Status of Deceased | Α |
| Record Number | 334 |
| Comments | Μάρτυρες |
| Fullname Registrar | Γούτας Κυριάκος |
|---|---|
| Age Registrar | 33 |
| Country Registrar | Ερμ |
| Occupation Registrar | Πλακουντοποιός |
| Relation | Αδελφός |