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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
Total No. fi elles
Residence
Charge to. ee
Address, . aia cre ciale 4. bee etal. «
A St
Pa re ee ae a ee
Sara ee a ee ee Ok
(Name of Embalmer)
OCCUPATION. ie on ies sais 3 oie din ob he et hake 4S oes Hair Dressing, $.... -..5;
ay atcha Underwear,$.... . ...
Name of Employer.. 2.0.6 T eee cee neees bees tects o se 5] Spit op POSE. .o.scccucsecuverccowcveeeevcs tie sees
Address
54 is $ at Kind $. Color)
ee a a ee ee ee ee Se ippers, ie ote, cnet ose, pee OR meg aces Reem aa ote
Disteot Dean PO Ce 2" Matos itt. Y Ys bem (Pmt. Folding Chairs, $.... Tarpaulin, $.....]}...
Pe (Date) Yad Candelabrum, $.... Candles, Wi. ale es e's wresalfes: fete
Date of Birth. .7 ven: ot / fos” ee cer uieeRibeena. cs wee atte Door Spray, $....Gloves. Go ag du Maeecrel. ne -scetik
Age : “ot SS ae ALI Vs wat SEE Funeral Car, $.... Ambulance, $..... [. 0.06.
aes ae (Years) ” (Months) (Days) Limousines to Cemetery...@$.....--]}.----Toate wt Beaneral. 5 os a ae ee teen m. Autos to R. R. Station.... OE Eee e s Bee:
; so HN a i ia Clear) Getting Remaing from: ss.. iis vine aes eee Mes pats
Services at. 4A/FOAGRVUE. 0.. cece eee eee eee eens Dalene Riemietns tos. ack cas oe deve Sa ue dloses a hes cle
Clergyman..... a, et tae Mea el rete) II piel ACO Trip to Coroner’s Inquest ....-+-+++sseee sere ees
(Address) Wel Verne BOS O! 65 e ao5 ce she's civia rd Oalbi eg aie coed = fhe
Religion of the Deceased HN Sei LT Phils 8 pg ante en Deliver Flowers to...ccccccccccccccevcccecll. so..
Birthplace Wroricebewn..ARMLOMABR. eee FVOTHOVEN Changee sis. boo) SG. 4!9 oie ale sietwarat at =P ales /;
e : Procuring Burial Permit. . feicsl sitited “sod-biseke’ WIT
PWIA Gp ew ole ciel de suaiolieie cig Gl ass emer an ict) . : capi! anda gi or City or Gounty) (Years) < (Months) . —_Certif.Copiesof Death CertificatesNo. Ed ,
é
tate cian’s or Coroner's
: Place of Death es Mate ec SET ee 0 Mie eb umes e's sree <> Pall Bearer Service, $. “4 Use of C Chapel, : $ a ahs cA he
‘Cause of Dea Personal Service.. ./.BOD. OD Noe J
: j ce" geal Causes. Pailin. = : eacet. a Pie, er ee he) a ae peel fe ty Dee
A EE tay lei ick 5 Bice o OeS NS RO 2k ata Dae Cale Gross Total for Sales Tax.......0..-$]}-..-GSV I OEGERNG « siteicls tun (re-anaait ea a claalssects © adellaemer oS Sateen Cana Cees PE . cme fe UM cocaine
His Address. . Angas. We Di.c¥,), diitbneeabi sae . line Death Notices in... Papers. foe ele
Oo ee ECE ae, J oo Payne oeieen Sate TRE etd memtetae tte nere renee steers
Name of Father Ura . Mics deep Seg Set. 4 ecu aus Pivwer 80. Palms, $ wee Matting, Ter ete
: His Birthplace: . ..6.s. Um Craver, i. he: Beara ie Rental of Tent, $..of Temporary Vault,$... . ...
Maiden Name of Mother. Y scherve Je? “Catteh eee Opening of Grave or Tomb. esa Pulp oe ees cepa el ey Seas
Lining Grave, $... Lowering Device, $...]}..-.
Her Birthplace.
Outlay for Shipping Charges.........]}..--.
Clergyman,$... Singers,$..Organist,$... ]..-.
Raitoad Wickets, Seats plane SEPViCe,$.. «p> «++
Telegr., Phone, Cable or Radio Charges..... ].--++
RRM BOVRIOOG 5 oo 5 caine wily ot di wtece ser pwincica py bee
Sales Tax 2.. eee, fae PONG ge, ik Eee
. Total Footing of Bill..... 0.0.0.. cee. $}. 0,
Re ee eo eed $i...
Balance.. 6. osc ses. Bites
aoe or below
. ay ho See .