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Q. Names Christian names and full postal addresses of one

or more relatives of the patient; A. Patient states Mr.George Gamble, 9 Clarke's Bridge, Cork City Ireland

(his brother).

Q. Name of the person to whom notice of death to be sent

and full postal address if not already given; A. Mr. George Gamble as above.

(Sa. )H. E. Fulford,

Police Magistrate.

True Copy.

(Sa.) E. H. Burrows,

Chief Clerk.

Wh 7

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