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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
DO IA nm ein a Lise ath ee ee aera mesg <i tals o\eke Cmts oH
eS. oe eee
eters A on ake, Complete Funeral .........-+--++:$ 388 es
alec ie eh. ak Casket. Yo. Agree eee ce cece ne nen ees 8.3.3).2.2.
Order given hy... Meer, cece tenet ene neeeeeeeees Burial Vault or Box ...-.-222--eeee ee eee ut GF 1.0. 8. (or informant)
(State Kind)
ees. Phere, _ ccewcuecceceeuceeccess. Embalming Body ... 0.0.0. seese secre eee reer eefer eee:
(Name of Embalmer)
Occupation..... ee g's lle tn . e poe Barber, $...-+.++. Hair Dressing, $...-. [---+++-. --+++Kckiel Rehecen Seame Dressing Body, $.....Underwear, $...5 fhe oe epee oe
Name of Employer.. . bef, fis Pigbeeie «+ 8 RRR GRE 4 Moe etn EMI 5k borane eons x nlegias oe treat ele wh) Mahin Wes gig
A AAAS (State Kind and Color) AGATORR o.oo: 0's ee Io Val ere Noe nisin eyo wa Bielain digrelniela Slippers, $.....0.6Hose, $.... i Me a Mela s oxdle
Date of Death.. Gan.. SS ae ee 32.8: (°~ . Folding Chairs, $.... Tarpaulin, $.....)[..-2-feeeee
, (Date) ‘ (Hour) . Candelabrum, $.... Candles, Soc ccins cans Pe vse dadpescss
X sigia Serete wis ele Aig MPT gee Bale Door Spray, $.:...-Gloves, $. 0.0.2.. -fJee cere cfr eens
lg Funeral Car, $.... Ambulance, $....-]}....]eeee
onths) (pays). . Limousines to Cemetery...@$...----sfeee ee ee fereees
a . ee Si 2 (°y. Autos to R.R. Station:...@$...ceeeeeeeeeeefeee ees
—(Hour) Getting Remains from......:eeeee eee cece eee efereees
TO GA i+ 0 b Taking Remains to. .°. 1.0.. ee eee cece cere ene en ee eeefereees
et eke Trip to Coroner’s Inquest .....++eeeeee rece eee efor ees
(Address) 1 Debivering Box toi. . dine ive <6 ase g sod cede mefe ates Safe weer
8 an Deliver FIOWETR 00 boccctelb oe sc odisle ns evan edine Pusu cee pcre ese
CL frntlerns.. Li ry) eee eee Remitival Chere ss 66 mens oye cee bowed ceils coe seefe cesar
Procuring Burial Permit. COR SaeP erst may hee yale
um) an Resided in the State../-. Yee os sissis'. __ Certif.Copiesof per ee em ate. Le
Place of Death ALzerecla, By Herdtsccer. Fidel os Pail Bearer Service,$.. Use of Chapel,§... ....[.--+
Cause of Death. (Le ov Lae ae Wee oe PRA bere coos, 5, bo Sia us eee, Moats gts ie 6) Bo hidin oil fe levee var tle flonase # ne
. contr Cn err Le ange A a Se singe nx Ue Ble SS ee pe Ee Le ree See ry ee eee
ay , Peed Unrcdrxtboc on ccacaciivalbvoens Gross Total for Sales Tax....26.16105 Bf e eg 9.)4 8..
. oe ’ itlar fo Lbs. cnecon sass > oS pas od e,
. Certifying Physician. ve ‘ “4 Tien. oe reg sere) Cadcation: PW eh Ts Se a uligidt vk y aca ca Lita alelei siete whe decom aipert eslatmalpelssecete¢
. ” ‘Bis Address. ; i Vids o ..line Death Notices in... Papers ... [sees eefe see's 2 ARRK“. UA.. coh sn dehy Uh os»
vp rg GS Re ORI ae ME ito ae ae a eens Stans + vag ee sa efits to afaa nes
Name of Father. Md, A : A. Pia. eee aes Flowers, $... Palms, ne o") Matting, pe! fd Pant Aer
His Birthplace.. AWQYITOTTY . occ ese e ewe c ones -Rental of Tent, $..of Temporary Vault,$..}}...-. .--++:
Siac Nt nl Wecthiew: dL ¢ ae Luke Lions aera Opening of Grave or Tomb.... seteeener dees eeesfeeeees
Lining Grave, $... Lowering Device, $... }.----+-. ---++ra Birthplace.... aie a ee ene sR Outlay for Shipping Charges. ......-.0s[lee cece efor eres
. . Cl an,$... Singers, Operate Mette. Gidhy tons bs Ship hora seal Ae sooseseenecs Sage aves § 8 ye haem
Brot’ b, ag . or Motors tickets, $.... 2: eee See, ere
Size of Casket”. 7,24 /. tanh “Coles aid ies A Goeth.. Telegr., Phone, Cable or Radio Charges..... J---+-+-. --+-+:
Manufactured by. go a on Riva ba thule . peas os Col AGVRNCOE oso oie cx debs ccc cc vine ace a eases ses enfesenss
—_ = . Out of tow: d , BER esas tack side ned aifie ntl siete aeioiers ter at lm Ale oor nen cen See aie eae lemeactaeerereth (cies ae
: Lot No. * fie pe oe intel Sales Tax ak ie ote to ees Cab ON
Grave No.. ...c0i0e8. Total Footing of By LE WN ale a Ae te $39.22 ¢. .
: S Fo ) =
: oe cede a ee Less.. 8.. Wt Tei RRC gH. .2.7.4¢ a.
, eaeeae Se ae eae ee $1.9. 7.9.13 37
~ Diagram of Lot or Vault -, Owner. ..... 2: cee eee. Entered into Ledger, page... or below
TDrtn .
. . Amount Paid . Ralance . Date .
. Amount Paid I, Balance fe ic ee Ge ee me ire