No.

Name and Surname.

Rank or Profession and whether Single, Married, or Widowed

When and Where Died.

Sex.

Age.

Name, Surname and Rank or Profession of Father.

Name and Maiden Surname of Mother.

Cause of Death, Duration of Disease, and Medical Attendant by whom certified.

Signature and Qualification of Informant and residence.

When and where Registered and Signature of Registrar.

81

Alexander Goldie

Factory <unclear>

( to Margaret Brown)

1878

November Seventh

Bridge Street, Catrine

M

82

years

Andrew Goldie

Woolen Weaver

(Deceased)

Mary Goldie

M.S. Richmond

(Deceased)

Epilepsy

as certified by

D. Sloan

(signed)

James Goldie

Son

Ford Street, Catrine

1878

November 9th

At Sorn

(Signed)

Thomas McWilliam