FORM OF INFORMATION OF A DEATH: ACT NO. 7 OF 1894 DECEASED: Christian Names & Surname: Thelia Gwendoline Flora TAINTON Sex: Female Usual Place of Residence: Komgha Age: One month and thirteen days Race: European Marital State: Single Occupation: None Date of Death: Thirty First May 1896 Place of Death: Komgha Intended Place of Burial: Komgha Cause of Death: Convulsions Duration of last Illness: Two days Medical Man: Dr. George Henry Knapp. INFORMANT: Original Signature or Mark. Allen K. TAINTON Qualification: Father, present at death Residence: Komgha Signed in my presence on this 31st day of May 1896 X.B. Gedy??? Witness When Registered: 1st June 1896 District of Komgha Registrar: X.B. Gedy??? Deputy Registrar Entry No. 45.