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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

230)
RECORD OF FUNERAL
ORE ING, «o's > B46 + ons eceee Weurly Oks. 0 pes ots teak Date. Litas. a a 19
Name of Deceased ae oie eee, ¢ Be Citta asl ay Cuan re a a 2A ue,
DY Marzied Cy Single Widowed 1 Divorced (What Race)
Residence. .722. Pes gat ie (io eee ee en ror { frets igh yc eee, oli.
Charge to: Lieve. ielnn de fr Sot ae Niele soba Le ee ee
Address,. 722. C5 Oe OO Complete Funeral.......0.. 02.00 $1 2I. .2
Ya. ‘tox ee Casket.... < "S enveed ie eae vs Cree LIANE
Order given by. £26 (AM o.oo eeeeeeeeeeeeeeeee Burial Vault or Box.........000000f eed,
(or informant) : (State Kind)
How Secured.. . Pee ae BSE ath ely eg aie Embalming Body ... EE nee cama Hl ae oe
.Occupation . . , (Sedtiiig ek ag Soe saeco cous Barber, $...... Hair Dressing, $....]]....
Gocial Security Numbery . Dressing Body, $..:... Underwear,$.../. ..../.
Name of EmpuoyeP ics.. shes acces cee fovnek fac checie oe IL Ree iiredemie gC Seas een
(State Kind and Color)
PIB eels Gite 9 se ous wh Piles oh 3 ceeeee Slippers, ENTE Ty Sapa ORE Se ones 2 Re a seal ae
Date of Death. ; ee ne ge G27 ° . Folding Chairs, $.... Tarpaulin S.A
ve i: (D ae a (Hour) . Candelabrum, $.... Candles. go ei eae
‘Date of Birth. . Deke ee ARSE Oe Pas Nee Door Spray, $..... cl: Se See se . eemealpe
oe abel ui —_ Funeral Car, $.... Ambulance, $...../. ....
s-enpiiea te ae 5 SiS ee (Months) """ "” Ways dD” 7 Limousines to Cemetery... GSi ee eee FES
Date of Funeral. Fc 4a ee, Sat w% fZ--.M.) Autos to R. R. Station. ... ee vb ee RG ee
nes ps Ae PY Week)” Fs a (Hour) Getting Remains from.........1..-H. oo..
‘Services at. : wextffee dtr-etact, . Shmfpeek.... Waking Stemaing tone oy.) oats cketa cy..
Clergyman: bane G// Akleas, pe, a Trip to Coroner’s Inquest ..........11....
Ze: DN Vene BORO ko Oss adie ee Ne
' Religion of the Deceased.. COSA a teense Deliver POGOe ta oe es es es Ce
Perna CRAIGS. os Med kn ioe nl doe Me
hplace . C.2cnwtwnett0e’. ffacer:...
oe : id, 2 Procuring Burial Permit. . Phone pier, Mamreey ae
Resided in the State. S. or eg Be ok : cnpen Ge, ( angel ‘. __Certif.Copiesof Pee ———_}}.. 2.
“Place of Death. the 2a. Leia Balt Pall Bearer Service, $. . Use of Chapel, $. ‘ AteY . Srameieeeaps. ae
‘Cause of Death. la Saas j ae aie Personal Service.... erie ee) ee
Contributory eae fea.. Mee Ed eae a mipey Meee d Uda Sie Welws Gos sh ould cues Ben RL
a wie Hide Nacpce a pug PM yeas as ucteld Goalie Sete aaa ihidiog® Gross Total for Sales Tax..........$H..22. .&
gt Ana 208 TE no os Gage Be ee
Centitzing P. nomena” Kz Cacas Ld, Cremation Ber wt dette via aay LA awe gl eT ian ah aly
His Address. :(-/ttmAea. (Laeby,. line Death Notices in... Papers oo. Asx ice ete.
Name of Father....2.... fa oD z eB Sep as Flowers, $... vans fo i Matting, K Sree aid . West nae pars! cai
His Birthplace..... ase B As, (are Rental of Tent, $..of Temporary Vault,$... . ....
Le Stet Saree Opening of Grave NR os los Ws os dev oo wae wo
se Name of Mother. ia) ee EL, cles bs 4s Lining Grave, $.... Lowering Device,$... ....
Outlay for Shipping 2 EE eye . ASA 2am
(i
Msery Remains ta Lead. = ey. NET OC ie lnc ce Clergyman, §4—7Singers,$. a “Organist, $. 2.. F126
%, x G52 S. C23 or Mond } Tickets, oe plane ne Service,$...]. .... cir wi
Size of Casket 73 °°. wee be pa sie amber “+++! Telegr., Phone, Cable or Radio Charges Lrmaad. . .. BIL
Manufactured dy: : Cakelomd: Reha Otol Poti aga ES A PCE eine 2 aso yest ng Seis vs Lie wasan bo
ox ee Out of town Undertaker’ s Charges. A Stizig calls waetie Souk ik
Interment at 71. Gaal Peeves.. { CREE is hbo ee See es ct ES ane
Si Lot No.. ...seeeeee eee: vs ew acta gU gr Si te Se He 2062,
Grave No........Total F ‘ooting A . Eee eae AG See gpaa geen $ Migeets, bio elhcds n+
Sectide Wo aie eS Tse WN = Ufenhee pan saeinaio ¢ ; eer H
a ames : fi pee en NMS ws are
Diagram of Lot or Vault Owner. .-.-.-+--5--+.0.02]: Entered into Ledger, page. ... or below. Dong ,