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Collection: Original Records > Death Records

Mortuary Records 1940-06 to 1943-05 - Index Included (324 pages)

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om RECORD OF FUNERAL eee eee OTe HT OM eee we eee eH H TT OHHH eee eer eeeeee et Hee eHeeeeeeeseeeeeeeses (What Race) { Complete Funeral ... 2.. 2.. e eee eee $. . . 7 3 t : Lo3 1/4 2fCasket.... FAA, i Ark A Es Order given by...%.. AE Nhe ds ki Burial Vault or Box ....-.0.:00eeereeeedfeeeeee. i (or informant) (State Kind) How Secured...! Phone Slane Step (UU mrt, ee Embalming Body ... pba ts ha habeus ON ay Occupation.... sits Sepa eae ck. cies a lesa mri, ee a ae Hair Dressing, $..... . ... fee (Social Security Number) . Dressing Body, $....-.Underwear,$.... /.... Tr, Name of Employer.... TE SOR cunt Sdnteie eid eee oteietes oe itor Derek ne kde ee gd : Ee eee cathe! teat a AGGreSS.. 21. cece eee cece ete c ence cence ere cen cece: Slippers, $....... Hose! Sc se se teanieeed se Date of Death, Aor 280 APTS oo.. 73°. dan, . Folding Chairs, $.... Tarpaulin, $..... ].... Ps (Date) (Hour) . Candelabrum, $.... Candles: $i.. tiara «cles buss ye Date iol Biren secs vices palate ag areas w. aiece oe 'ale ek rSlbue. ole sie orem Door Spray, $..... Gloves, $... beads aR ee jen Funeral Car, $.... Ambulance, $.29.%.... 251.0, Sy Reo [smu Colors.. rioters, aeaa’ ~ Date of Funeral . Autos to R. R. Station. ... CI SO rece MC . gu ears LE . : Getting Remains from. .......02.e0eeeflee sees 5. Services at. 7% Taking Remains tO.. 5-066. ccceeessces cs cPovce ses w Clergyman::.. hao. . Ire CrP. 5 Re A ee ee Trip to Coroner’s Inquest ......++++++ +f.. a0 a : (Address) US go ee oper, SSeS a eligion of the Deceased.... Vette eee eee e eee eeeee ees Deliver Flowers to....ccccccccceccevcecsie. cues . Birthplace .. Aaradkh Yothey ll SR MeMOVal CHAPIOR ooo. cites cece erwnstee sols cc ees Ms Seat i elle ; Procuring Burial Permit oo oe once sz pit . ee ‘um! ani istrict’ iepraiandk> cies f: Gis’ cr Goint}-~“Waar)*” (asuris) ". __Certif. Copiesof Death CertificatesNo.—_. . .... . ; (State Physician’s or Coroner's ) : Place of Death. Ya: Pall Bearer Service, $.. Use of Chapel, $... z Cause of Death Xtm a PERSONA SERVICE: soa cie ola) cies e cere cd othe inne wiolallfeguesgalane Contributory Causes.....ccccecscscestocegcccceess lk eee Ae ge aie aa ek eae SMES ec ee eet co eee een. Ree OM ee Br EG Sie vc cad cle vacated sabe sees ak Certifying Physician, = Cremation gt ar rumen, GU eg Basie ie a lh Cork A eapeakek....,.. *---Hine Death Noticos in.. . Papers ....J--.-..DE ee tiered <i ks ar Sn tan es of Nee ee . “* Name of Father. Oe Py dai DAO, ccc eee eeeee Flowers, $... ( p i 3 yey mt RC aa i His Birthplace.. .4“1.04 . Tokhog tate, oe Poets eeeeeeeeeees Rental of Tent, $..of Temporary Vault,$... . ... Bs le Maiden Name of Mother.....02 BASE ly es, Opening of Grave or Tomb, .... eee (esas “. Lining Grave, $... Lowering Device, $... .... is Her Birthplace. ... Abwatd v abeeg, {tae Outlay for Shipping Charges. ......... )...-a Mor) Remains to.. .++++oe me te ee ee ee ae Pe . korg oe Motor} Tickets, Bisinks "++ plane Service,$...}]--.--. » Size of Casket.. 4. !. ial Col oe ee Telegr., Phone, Cable or Radio Charges..... . --.---‘e Manufactured by: Aaathony, 2 @ Sree ela banace ead aelge saad a rite aa Shelas tee ee? ey, MS Te er re to ertaker’s Charges....... ].-.-Interment at. Adare ee eeeeeeseeesees ie oe ee ee Leto. so sereedecenesn} a POE rete Seen Sate ME! Cicad bias oh ea Total Footing of Bill......s..0000-g. 204). é TMM, chic seve Saas Coes soe ode Oe ee , Section NOs. <5 4s\slaiem 400 0's ga ae . ee ad ee — Lae ce alances << Sette seo) Shes. oes s Diagram of Lot or Vault Owner. ....-.-..---! Entered into Ledger, page. .-:¥.or below. © -