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| Year | 1897 |
| When and Where | Thirty First July 1897 , 15 Kings Road Clifton |
| Cause | (This information has not been transcribed) |
| Age | 68 Years |
| Occupation | Widow of John Derrick Blacksmith |
| Informant | John Henry Derrick son present at the death , 15 Kings Road Bristol |
| Registration District | Barton Regis |
| Sub-District & City / County | Clifton, City and County of Bristol |
| Source / Reference | Death Certificate , Family Record Centre |