Cζrem(onia) supplet(a)
a me J(ohan)ne[?] Grimston[?]
Die 28o Nov(embris) 1863
The rites completed by me, John[?] Grimston[?], on the 28th day of November 1863.
I think the words in pencil underneath are Sine Caeremoniis = 'without rites', and this was later overwritten when the rites had been performed.
(This sort of wording is used when a child has initially been baptised privately at home and the ceremony completed later in the church.)