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Approximate facsimile of original copy of Record of Death

TASMANIA
The Registration of Births and Deaths Act 1895

RECORD OF DEATH

1405/1923    District of ZEEHAN

Central Folio

No. C 0968/1923

1. Surname of deceased
2. Christian or other names
3. Date of death
4. Place of death
5. Occupation
6. Stated year of birth
7. Sex
8. Usual place of Residence
9. Reputed birthplace
SWINDALE
John
27 September, 1923
ZEEHAN
Engineer
1858
MALE
ZEEHAN
ENGLAND
10. Conjugal condition at death
11. If ever married-
           Name and surname of last spouse
12. Issue - of all marriages

13. Age at each marriage

MARRIED

Not stated
Living males      1      Living females
Deceased males        Deceased females
43 (first)       (second)
     (third)      (fourth)

14. If never married - names of parents

15. If born overseas -
           Period of residence in Australia




40 Years
16. Date registered

17. Signature of registrar

28 SEPTEMBER, 1923

J.S. LEITCH

 

I  CERTIFY  THIS   TO  BE A COPY  OF  AN
ENTRY IN A REGISTER OR RECORD KEPT
BY  ME,  GIVEN  IN  PURSUANCE  OF THE
ACTS OF PARLIAMENT OF THE STATE OF
TASMANIA THIS 26 AUGUST, 1992.

John Jameson
REGISTRAR-GENERAL

COPIES NOT VALID UNLESS CERTIFIED

Cause of Death:    Heart Disease (Failure)
Attendant:             DR. C. Rieger
Informant:             M. Kean, Coroner

Coroner's Inquest held at the Court House Zeehan
at 3.00pm on the 28th September, 1923.

(Inquistion papers add no further information)