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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
ww ee ee PEO Oe ewww ewer eee eee eee etree eeeeeeseesreeenee o(What Race)
ile “f. Banat! aia baaes . Va Ege En Complete Funeral.. pagan tg Site, om
Casket.. ¥. Aer eee ee Re by bt
Order given by..... arr BEE ete Wine oy vin 58 ain ae ole op Burial Vault or Box ...----:ccceceeeeeceeteceeeee
or informant) (State Kind)
How Secured.:..... Phen. may A ee PINS OG ois Vics lcae ote oY se aie 2
: (Name of Embalmer)
Occupation......... Tisai achat Aelia hee Barber, $...... Hair Dressing, $....}]..-.
i (Social Security Number) . Dressing Body,$..... Underwear,$...!]...
Name of Employer...... gp 8 A mR Che ace Pleads MS ily aces set OM ei
‘ale
(State Kind and Color)
PRGONCSS a) oo 0d Sac cree «are Barely oobi muse wie Opis sy leew efhiaigia we: ¢ Slippers, $...... ' BOS) Seta: 63! “pees
Date of Death iby, 2. Wi eine (242 «eal ho Pee 46 Fin, . Folding Chairs, $.... Tarpaulin, $.....]}...
(De (Hour) . Candelabrum, $.... Candles. Sci. 2. so Pa os ee
. Date of Birth. Miah. ee kas [EGE CPabvereaoyen eatlee ps Door Spray, $.:..5.. (GIOVOSS Ds Gigiaecdocitss Ee so ee
Noe 73 vA) / Funeral Car, $.... Ambulance, $.....]}...
rs ana (Years) ” Qfonths) 77 ¢ 3" 5 ae of ". Limousines to Cemetery... Ge Bolle Buena a
Date of Funeral“ ba. MS cbrgadey,..2%, 92.0. m. Autos to R. R. Station.... Ct aoe: Ra
a a oS Getting Remains from.......-.eeeeee ele ee eee
Services at. MY wytt7. ¥. \Mvacevr ‘ Cee betes Taking Remains to....-.eceeeeceeeeeeefie cess
Glergyman. : fied “1 ah. ; CK asl an Saas) ae Trip to Coroner’s Inquest ...-...2e0eee-ffe eee
(Address) PCH Verran BOR LO: 08.5 eee no «wg selon bite el slo nerd As
Religion of the Deceased. . Deliver Flowers to....cceececeecereeeeeed ese.
FUCTROVAR OR ATIOS «sis <6 «nie svn 9:0 ote vind Sania y OMe puss
Birthpl
sgt ‘Ss 7 Procuring Burial Permit.. std Setcuied “and baby
: Recicocinn the Serta 5 (or U. &/or City or County) , (Years) ny, __Certif.Copiesof Death CertificatesNo. ——. ]-+++.
Place of Deathay.3.0. Laer” Prem, At, free 3 S Pall Bearer Service, $. . Use of Chapels 6. slihcrel Map r
Carnac of Death aie Ba Sea ea Personal Service.......seeesseees seeee . ee
Contributory Causes hirele. of dw fenakh. Se oa gl boel Peeters: 9 new Se Rastiadea a gn Iota er ate uo RS gous isaac esate iptug Sue ete FI etaey ceaete
Tact ate Sige ayaa le, Updates ctid ac w Plg pune ne eee Ua Gross Total for Sales Tax......02.2--$]f.. 2.9
Oh GIAY POT Gb os he hs odie becore Sle ecw 0: Susdacaene tere . [era ces las
' Certifying Physician“Sv<7Tye. A . Prodler. enn ore Cremation Pn Geer i eee ee anal, 2 eae
Eis -Addvom. ry, abd. da. une le ee. ..line Death Noticesin... Papers sees eeees
Len eee be bee hint di Siataa ss = 2 = see es «= ole ra =
Name of Father. a ct dae abil are a aa edge Flowers, $... Pal oe soy Se ecers, 8 oe Matting, Se Te
His Birthplace Se cards eee Magan, coe Engler. Rental of Tent, $..of Temporary Vault,$... }...
Opening of Grave or Tomb........--. . -2+:
Maiden Name of ya cee Ri Lining Grave, $... Lowering Device, $... . ..--oe Her Birthplace Edad, ITT oie for Shipping Charges. ........])-----a og ‘Clergyman,$... Singers,$..Organist,$... . ...
Be yi gioea 3 to Railroad rp;
oa P; ' , Tickets, $.... Oo” Service,$... . .----“a a4 of Casket . F 1507/4 a Levee! Pheh, OF AL Comes, pa Motor} genssee (ete Caccant Nuke (, Telegr., Phone, Cable or Radio Charges..... }--+--cca ~ Manufactured by.. ge ia: Ss ial x a ceeee a Paek Advanend.. . ucts. ssi. sestecsiaeeebeetees
‘ = Interment at.. MVeclorann Ft este eiadee wees ao-ariid Sean cary eta Toate ‘ ‘Waser i Robin ie Ei :
ky Se Oeil ouia oy Pepin
. Rs Total Footing of Bill..... 0.60.00. 000. gle 7. ¢
1 Paras arte ota Meme ee weg ic “Cul ytd $H. .47
ee ——, . secre Balance..::....:. $i.. ..
* P Diagram of Lotor Vault =. Entered. into Ledger, page... or below