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Collection: Original Records > Death Records
Mortuary Records 1940-06 to 1943-05 - Index Included (324 pages)
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Page: of 324
RECORD OF FUNERAL
Yearly No....
er 2) ieee
fl Married CO Single
eo bie oc oree 0 6)4 ww BRle wwe owe el ewe Bere Hee
Order given by Siete ate Ma Meck ee ae
a
Oye eet ca Date. Lbye eee Ae ceeredt
e Teacney SE Saree
a a taaones rt ch
(OBusband[_Jwife[ JWidow t
eeaaraet pee Beas Tn aegis be
“. Complete Funeral ...--ee ae.
". Casket... A: POO
ae ld
ss .. Burial Vault or Box ..-----segrcrrr ey
. informant)
(State Kind)
How Secured.:..---Sn, pn Ses late ae) Embalming Body ...-----ensees pep
(Name of Embalmer)
Occupation....+-+++65+ ER pe Sete ce ee Barber, $..-.-+-+++++ Hair Dressing, $..----l]------:
i “** (Social Security Number) . Dressing Body, $...+-+-Underwear,$..---l]----++-]Name of Employer...---+seseerrrrrer Grttay PvO8S facie veces nolan fo eens eee ra tet
A dd: —_— i (State Kind and Color)
EEE oi ccad Unt avd Wen Os deo REESE NTRS eRe EES” Te Sligpers, $6.. Fuses Bone, Sos vals occas alain es
chite ol Bath ote! 1 PR.. a6 f°, . Folding Chairs, $..---. Tarpaulin, $..-----[--+2-(Date) (Hour) Candelabrum, $...-Candles, $...-++++-l}eerere?
Date of Birth.“/ BR" LES ee Whe, wa be cesncunes Door Spray, $.:--+-+++ Gloves, $..-eeeceeeferereee
Age 49 g oS Funeral Car, $...-Ambulance, $...--++\Je-se+?
ES ales ae mean oe. ae Limousines to Cemetery...@$.----+00e-[ercre
Date of Funeralaty 26.. Arvilay oe eee eee 73°. Py. Autos to R. R. Station. ..-BSc: et
(ome) (Day off Week) (our) Getting Remains from...+--++++ssrerrrte ei
Services at: : Al reper.. % AAMT. . CArogtsh. veces Taking Remains to...---+ssereeersreese ye
Clergyman: :. 7%.. ME: cn or Ee Trip to Coroner’s Inquest ..--+-++++errrrr effet
(Address) Delivering Box to...---seeesecressecr et per rete:
Religion of the Deceased...---+++-++: SW eee we aes Deliver Flowers to...:seeccseecrseserreredes cess:
Birthplace’. . Loree. tae Chaseodert ‘Dida Sate Removal Charges...-+-Hp ettlesniinegn . a 3) eae
i odin he 26 Procuring Burial Permit.. ei ee Mae
Se eae 1 SOR so pero 3 i umber an ict)
sh ae a ‘(or U. S. or or County) (Years)' — Months) ___Gertif. Copiesof Death CertificatesNo =i ea
a . . ician’s or Coroner's }
Place of Death, fact Merve, Meryschoks. .-++. Pall Bearer Service, $.. Use of Chapel, $..-. .----Cause of Death feet! ee Perabredecg. daveovecle oY RETRO SOS nhivs alec * RMR! eS
‘ Contributory Causes. eyeety. Drrakyuw, % leg Vy SRI = ee. iets Oar eae kee Seen
Cidemaavee 2 Ap > Sham. ormroas OH, of. Ciyna,1, HaseGeoss Total for Salon Tar. ssc5 phen hte re
ii ee are Outlay for Lot...+---esee neers ae 8.9,
Certifying Pyparetan. Ws. fees cone) TTIW.» Cremation...--+++-seeereteee JU ke Sane
His Address: :. Adve 2 Uatles penal Be Geis: _..line Death Notices in... Papers ...-. ---++:
of, 1 SE ae oii [EB EC Sac CUR pe ta as ( eoeee of . ne Pe ae ee ee iss weal 6 SRE Fit
Name of Father. CTYueee eet fee bly we teee oneness Flowers, $... Palms, $ paren) \ratting, SS eee
His Birthplace Of 7-7 9 Quarks Lael Pet aaa Aeon 5 SR Rental of Tent, $.. of Temporary Vault,$... . .----Maiden Name of Mother. CLna oe Larlt, ICT ok Tee lator Opening of Grave or Tomb. eae ee a
—— Lining Grave, $..-Lowering Device, Pree, paeine,
Her Birthplace. Seperg hegre. ca Outlay for Shipping Charges. ...-++++2-00¢-fpooees
Motor : Clergyman,$/%™ .Singers,$. . -Organist,$...]--++bd
Motor} Remains to...-+-+ ag lele. a ae BIST Rinie & eee ee Seen »+. Railroad . ts Aero;
i a Coden $l “i J 5 As tee et Moa) Teke Se cca es plane Service,$... . ----++
pee er ae (State Colpr ang Mamber) Yr «+2 egr., Phone, Cable or Radio Charges...---\Jee+ee>
Manufactured by.:::-Moan Se é PISAL Cleaners s Cash Advanced. ...--c-cessccrcssce ert yee”
. Out of town Undertaker’s Charges..----+-+--orrrt:
Interment at.. Clr.» Portas eeennee HF ovnsn i REET an Coe oe ee ee
Lot Nowa eseeeeeeees a
Cinseuts Bloc; APIA sa vais 620% Total Footing of Bill....-----eeeeee eee: $ JL?
Less.. 202» MAL LAMAIHG. «0 eee e cece renee LAE
Section No..++-+s2ee99"° $ as
1 1 r ; ; Balance...--.+-++++$ &3 iS ?
Diagram of Lot or Vault Owner. .----+eeereeeeee” Entered into Ledger, page..-.-or below.
. Ed . Amount Paid .