| Consecutive Number | 67 |
|---|---|
| Day of Death | 27 |
| Month of Death | 05 |
| Year of Death | 1917 |
| Place of Death | 85 Scholes |
| Surname | Cusain |
| Forename | Charles Bernard |
| Address | 85 Scholes |
| Township | |
| Age | 44 |
| Occupation or place of work | Greengrocer |
| Name of Official | Dr Elliott |
| Cause of Death | Natural Causes |
| Verdict of Case | Natural Causes |