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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./.7.9....4500Yearly Now.. j..ceeeeeeees Date. Miche.. dir coe
Name of Deceased. Oo 2274. A OE LL NEO E Neal necator EIS coogi c ePice esiaieistite9/ somes inG OErErEe a
Bd Married D Single 0 Widowed CD) Divorced (What Race)
Residence: Al nats ; Uallies Cael gles siicateMeln cules ds e's a e"eieee = me $e eer
CR ee Oe es ee ea es
Charge to:. Cramed KTR, oo 4A LLCO hs wie dateres Sorin ; $
Comp ete Bureral 2.. kes hee ee oe eRe Pe Soe
ai stel ae) SA Ae Ae PO
wap ie rad lisa. Casket... We REIGN ots De ss ve been ee LAG
Order given by..... Aor, een atte lis did dahon eee Burial Vault omBex ....0.0-0ece cece eee ede. bee
, (or informant) (State Kind)
How Secured..... Phan. epnepet iaetehi Crd waa bw ABS Embalming Body ...... 00s eeeeeeeeee eee ee
(Name of Embalmer)
Occupation ......0.% Ah rash teabbciada sl dita tei ea Barber, $...... Hair Dressing, $....]..---.
(Social Security Number) . Dressing Body,$..... Underwear, $.../....
Name of Employer.... 5 ...eeeeeer eee e settee eres Sate OF DOM ie os eva a ot Ee oS nna popes
as : . (State Kind and Color)
POMOME in bea oe ven a Case olemin ene aie Sewanee eevee Sh. Slippers, $....... Hose, $. ET is eae:
Date of mnt at LT TMs eles Z.Gm. . . Folding Chairs, $.... Tarpaulin, $.....)....
(Date) (Hour) . Candelabrum, $.... Candles, Bo os wikis 's cafe oh meee
“Date of Birth, Yang.. MLg ec ccees 5 dein i Door Spray, $.:.-..Sot ee
: / fect Funeral Car, $.... Ambulance, $..... . ...
visas a nar fe meee fonts) 7" ( Rak ee Limousines to Cemetery... OS: 6c. ace Gt
Date of Funerat7/ mati PE Rates oe ae. la m. Autos to R. R. Station.... Sis eae ee alfes ee
(Dag, of Wag ew) ‘Getting Remains from........0000ee fleeces
Services at. et. yr khan. Pragtoks oo.. Taking Remains to.. 5.. 2.0. 0seceecseewtenffeseses
Clergyman. J Zarv 2. Ciach. a CK. doe as tee Trip to Coroner's Inquest .. 2.. 666s. eeee sce. ose. .!
(Address) Weliveriiwisox tO cca pte! elec sce Meas sols 3:0 eiehelleion dete
Religion of the poe, : aE SAS ct a SUSE i re ed ae Deliver Flowers t0....cccceccceccccevesecll cece.
lace.. A nKsd. ) SE earn che HERIOVal CHAPROS 3. 65-5. Sic «015.8 s 0's oe 'ewieieie otale ales
re ea ally Procuring Burial Permit. Seed wet Nate “Ea a
Resided in the State.. , fe. ss iin") ain '] _Certif. Copiesof Death CertificatesNow . ..
Place of Death 4% etune. 7 Naotpehokd. a . oA oe Pall Bearer Service, $.. Use of Chapel, $... . ...
Cause of Death Garedenre. ys. pera Ler ne POPAOGSE BORVIOG. es sas iecsinig code nope doe Me ates
: insane. Ae na tee Fr at Re ee a: eI Soe
G2r9ss Total for Sales Tax, . Oe earn aes ceeeetee lees one é
“heute 1 Boron ster Ualatne Pateiea velo: \eelan
ao LAA eee Fede ack Wiis kc
is Atdvene line Death Noticesin... Papers . fcaib ee. oe.
ee deck SE ES Gikctiiecceag TTT terete peers
Name of Father. Flowers, $... Palms, $. Matting, $... . ...ene, ep tg wee eeeeeeeee+-. Rental of Tent, $..of Temporary Vault,$... }..-.
Opening of Grave or Tomb.......... [-----_ Maiden Name of Mother es LERMA, occ eee e eens Lining Grave $/. -Lowering Device, $... . ..-.
‘Her Birthplace.. “~~ LUA, UV eMac cece eee Outlay for Shipping Charges: id o5 sss ae clea bees == ee ;
Motor} Remains to.. oeceecevetevsecesecees,. Slgrayman, $4," Singers.. Organist,$....--#
¥ 330 hy a phi. = Mour }Tickets, ie ee alar ees plane Service,$... )-----.
Size of Casket.." <2. icles Caaarantinegrang oa a acim Telegr., Phone, Cable or Radio Charges..... . .-.-Manufactured by...OethnS Be ED ve mph RTM Siete oem, ilk
CL t Cemetery. Out of town Undertaker’s Charges....... . .--+-Interment at...>“7.. Tec Ft ‘ feeseeeees { ceamateny], 7 Sp SR Er, SE RyNES MO. anew cm: Gee
ot ee ae aA ee ee mS en
“s Total Footing of Bill.. .......005. $F 28.
ee ge ends whe na bie wa ow a wale ale bate SH.. .ow ey oy Balance....... . ies
Diagram of Lotor Vault =~ _~ Entered into Ledger, .-..0r below
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