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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

Lod
RECORD OF FUNERAL
Total No./5°7.....0Yearly No........0-Ses Date. (Uayape ae ee en
Name of Deceased. Ukliwnn. ecrhe. ee Chern, se IRA eal oriole 6 slags ah Ga nse, . J0-) sp cates eb ola -Nas anes gp PUMREIN bg lS rsihe Bo
Married Single 00 Widowed JX Divorced (What Race)
Residence. aad, ; Of Ashe A eS 5 ol Ge Ee aa erent een Picea cote 1 Puente Say
yi ZX. ~ OR suas levees s teed of
Charge to:. K Goan OER so cask alnia ab sdawe. 5
ae Complete Funeral..... 20.02.00. eee ee Bi. wee.
Address ul tom
eh ar Sask Eh ae Peg wh elm SN: 5 MN, cave tae vlnulentl. hae.
Order given by Zine i. Tarbrarcte cpr ere eree ss Burial Vault or Box .....000cceeee eee eeeee eee.
(or informant)
7 (State Kind)
How Secured. :... Chon. me ee RT a Embalming Body ... NI eae. ie eee
RNC 2-25-5's 5-Sh vs oe wa at pe ecules «oats Barber, $. 00.6.. Hair Dressing, $....]]....
(Social Security Number) . Dressing Body, $..... Underwear,$.... . ....
Name of Employer.... Tete eee e eee e ete e eee tees: CG Oe PIG i ois wk hak ow a pane 4 see yo Seale aed
pare (State Kind and Color)
PGI 6 cin gta lhe 6 SORT by ia nnk Spline wk Vl RAN Gm ew me Slippers, $....... abe svc vioteclt A My as Ges
Date of Death. H40v. 24". ./94!... 12,20 2 mm . Folding Chairs, $.... Tarpaulin, $.....]...
(Date) (Hour) . Candelabrum, $.... Candles, $. ois eo les
Date of Birth.W4... TRIP ove outy Lipa Save onlin 3 Door Spray,.$ 2.. 0.. Gloves, Se oo. estes sea
Age F $7 Funeral Car, $.... Ambulance, $.....]}....
rapt atte Gao (Months) (Days) ay te a Limousines to Cemetery... OS. 8 hy Re
Date of Funeral.~ Le ae tam. Spam / 2?"/7% . Autos to R. R. Station. ... eo aero ae
na ah (ee) “i (Getting semaine TOM. 3. os cies Ces te ead ie dae os
_ Services at: a, ap 1 Ye CON AUYT, . RMA oes Taking Remains to. ......scececeeeeees. e ceases
Clergyman: : Stus. Mak Oo oe, Sera Trip to Coroner’s Inquest ........00-foo. eee.
(Address) Deu Vering BOX GOs sc. <cokoe i ale sind ondiss weletue em Sioa ae
Religion of the Deceased.. y......eeeeeeee serene. DGRVOR DE 1OWEES TO s5.5.5 5 55 os 6 spn si ele tigers ow efi. oo
Birthol a Corr enreth a 7). a REMOVE OHATRORG ial Sees Soave eo cl eiale Mone ott elalecus'cec
“aid g Procuring Burial Permit. ee nak nies ss ak nfs hes
Peet tne Satay fii "ia "ais . Cerf Copiesot ee nee: See
Place of Death. Covorky, : Mecyfirter, Purreda Nh ee eh ay ee -. Pall Bearer Service, $.. Use of Chapel, $... . ....
Cause of Death: “egeveterny.. Zankome, ts Frageonal Service. ...seseeseeeecsee esses peeeeee,
Contributory Causes. =e Aken Bins Bf ckcitiscplvon Susbavtere toate Uetetelect ics cite oes taeers: ana vis helms aeere Mase oe lauds
Gross Total for Sales Tax........0005. Eee /.
MD LOR LANG cc: ote slg eie laure ed dell eer ARIPES martes
COSCON cals sik n tors eaiate Wb WE Es n ON ocd ani es .
line Death Notices in... Papers.. ule. io
Flowers, $... aa ; Matting, Se toeltesrc ie teers
Rental of Tent, $..of Temporary Vault,$... . ....
Opening of Grave or Tomb.........]).-.--Lining Grave, $... Lowering Device, $...]}....
fad. ...... Outlay for Shipping Charges. ......... ..05.
Ship weer) Remains to.. torn hare, . Daaanmete. Ghd.. Clergyman, $ ne fe Singers,§ . =: Organise, § oe edeane
+) ath Kn or Mont. } Tickets, , ree plane Service,$... ]....
Size of Casket . ae os pu ce wet ee eee ees Telegr., Phone, Cable or Radio Charges....]... d.
Manufactured by. : : oe OD stg PP Ca eee ep ——— Amba fs laos SPOTS © week
ut of town Undertaker’s BS opens eos ts ba
Interment at. Levers, slam Peremer..., fe OE eg Me. 2 agli sa Mes Beet
Lat NO. ooadesessee Gt So pemsmpmemitomicn get) Mas
Gate Rout cole le: -_. Total Footing of Bill.....-2ceeece eee. $l. 7.<2 8.
MMS sicnle thle ea dia» Suled cele oe al sale oe see RTE
Section No.. <..ees<ee: a E : =<
— ——
ance..cs. i502 SEBS.
Diagram of Lot or Vault Owner. ..-----++eeeeeees Entered into Ledger, page... or below.