This chaplet for the dying is adapted from the prayer which is in the Raccolta.
On the large beads:
Most merciful Jesus, lover of souls, I pray Thee by the agony of Thy most Sacred Heart, and by the Sorrows of Thy Immaculate Mother, wash in Thy Blood the sinners of the whole world, who are now in their agony, and are to die this day.
O clementissime Jesu, amator animarum; obsecro Te per agoniam cordis tui sanctissimi, et per dolores Matris tuae immaculatae, lava in sanguine tuo peccatores totius mundi, nunc positos in agonia et hodie morituros. Amen.
On the 10 small beads:
Heart of Jesus, once in agony, pity the dying.
Cor Jesu in agonia factum, miserere morientium.
At the end: Gloria Patri, etc.
Another useful link: