| Consecutive Number | 124 |
|---|---|
| Day of Death | 26 |
| Month of Death | 11 |
| Year of Death | 1917 |
| Place of Death | Greenough Street |
| Surname | Forshaw |
| Forename | James |
| Address | 133 Platt lane |
| Township | |
| Age | 0 |
| Occupation or place of work | Nil |
| Name of Official | Nil |
| Cause of Death | Natural causes |
| Verdict of Case | Natural causes |