No./Name/Occupation/Sex/Age/Condition/Where Born/Parents Name, Whether Living/Occupation/Date & Place of Birth/Certified Cause of Death/Sign of Informant/Where Registered and Sign. of Dep. Reg.
Mary Day F age 70 Widow Kilkinney Died 2 Oct. 1867 in Salmon River, Stomach Disease, informant Patrick Day, registered 24 Oct. 1867, D. Lawlor