The Births end Deaths Registration (Northern Inland) Order 1076, Article 34
CERTIFIED COPY OF AN ENTRY OF DEATH
DEATHS registered in the District of Toome Ballymena BK5
No Date & Place Name Sex Condition Age Last Rank Certified Cause Signature When Signature
Of Death & Surname Birthday Prof of Death Qualif. Regist. Of
Or & Resid. Registrar
Occupat.
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)
25 13 May James Male Married 40 Fisherman Drowning Cert. 16 May James Picken
Lough Neagh Campbell Accident Received 1881 Registrar
From P
Taggart
Coroner
For
Co Antrim
Certified to be a true copy of an entry in a register in the custody of the Registrar General and given under the SEAL of the General Register Office Belfast
this 21st day of March 1897
The Registrar General shall cause any certified copy of an entry given in the General Register Office to be stamped with the seal of the Office, of which
judicial notice shall be taken.
'
CAUTION:- Any person who (1) falsifies any of the particulars on this Certificate, or (2) uses a falsified Certificate as true, knowing it to be false, or (3) Passes as genuine any reproduction of this Certificate, knowing that the reproduction is not the Certified Copy is liable to prosecution.
Transcribed by Jonathan Engstrand
