Name and Surname: Mary Carley
Rank or Profession and whether Single, Married or Widowed: Wife of a Waggoner
When and Where Died: 1860 Tenth July 4H. 50m. am, Whittles Str., Quivox Parish
Female / Male: Female
Age: 26
Name, Surname Rank or Profession of Father: Robert Blain, Coal Miner Sinker
Name and Maiden Surname of Mother: Margaret Blain M.S. Caddies
Cause of Death: Probably exhaustion resulting from parturition. (Due to child birth)
Signature and Qualification of Informant, and Residence, if out of the House in which the Death occurred: His mark Peter Carley, Widower
When and Where Registered and Signature of Registrar: 1860 11th July
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