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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...... are bunen Wearhy Noi. 22S so caeee teense Date. ~4#244".. he ce 1
Name of Deceased . ; CPt dice Le hoskevedt. pe er Re coe nie ratcrshersa WAnrite pane Bisleu
EY Married C Single (0 Widowed LD) Divorced (What Race)
ewideiade:. Hane, JRAS RGR. Bik. Sais saan ge pia aa aaa me Eerie mnie lbs otek
"Charge to: HZ [An2Eenetee . . ee
6 Complete Funeral ......00.000.eee ee: $. . 277 . :
‘Address. BCE Be Mee Ft ke oe eae ye
dae r Casket.. CLI CAN GEM. cece cece ZO, ‘
Order given by. H. = sg pif nes cand ee eeeees Burial Vault or Box ....saa otto
ory (State Kin
How Secured.. Gre.. Pc ate, eR Embalming Body ... Siete Ce :
Occupation.. EAA AREA. fauna os ell oe ea ogee Barber, File. vc sees Hair Dressing, $....}}.... :
(Social Security Number) . Dressing Body,$..... Underwear,$...]].... ‘
IWaamie: Of ENIHOVER coils ou oe pices anrenss wan etaiere oe aek arnt Sahny ieie. tek ees ee ae
(State Kind and Color)
Address ..+++++-++++++ de eon b Soa TE hand et ae esters Slippers, $.....00. 2 OT TREE eae a :
Date of Death. A AA f42..2/ tr. .\ Folding Chairs, $.... Tarpaulin, $.... He..
* (Date) (Hour) . Candelabrum, $.... Candles Ss sie celal Gawd :
Date of Birth. . WBA AKBLE CZ. cc.. Door Spray, $....Gloves, 3.2 aes :
i i CE hott Fela’ Funeral Car, $.... Ambulance, $.....}}.... ;
: ae Sa eS ee a oath eeliPtey (Days) Limousines to Cemetery... 2 ; SR. phate one oe cle :
Date of Funeral. As (42 Lhuaret.. 2. tim) Autos to R.R. Station.,..@$......f... :
ee) + ce. eas} Getting Remains from Ame Pet Rites all ee <p
Services at AT. A et Areagech. setees ‘Taking Remaaine €0 6. idncys oe o's ea ois bec cee se eu A
Clergyman. : se Pe # pM OA Reema lira tas” Trip to Coroner’s Inquest .. 2.. .seeeees fee cess :
‘ (Address) Plehrvering BOs tos .05 fc 6 sas oko od dime o's ois ¢ oalers ‘
‘Religion of the Deceased. V3 Cae LEM Prd. eee Deliver Flowers 16.5).. 62. svete cee sce. occ.
1 aes hse eeeaae. Ay) ee Pel oan Removal CRGMGR yi . cs aes scp cctv asic ele tae Penis eek
eee: sag Procuring Burial Permit. +.. cossoeepoee eo}
Reedad Hehe (or U, gfx City pr County) (} Apa.. ‘. _ Certif. Copiesof Death CertificatesNo.____. ]....
. ‘3 s i (State Physician’s or Coroner's )
Place of Death.. & hiaade. . FAG Hs Pall Bearer Service, $.. Use of Chapel, $... . ....
Conse okDeath, 2 = ane. Csi Se See Personal Service..... ee 5
ge a Causes ane ‘ ee Pane iF ce. See Te aa Nea deteatiste 7) Uae a iy Ble ee Sem ite ss
abate 5 en a Sy aad acai <e.> Sal Oe mas Peery 4
Outlay for Lot <2. a Kdge ‘ ms tthe 2 ee one
Certifying Physician...... tea es Cremation (oa ee asa loc ain ois oo Lie ee dae
a His Address’: — Gaz > ee Beer ace ..line Death Notices in... Papers .... . ...-;
ee . ee
Name of Father Flowers, $... Pal 78, i een : Matting, Sree Nae ;
His Birthplace.... aa eo rg as Oa” ee Rental of Tent, $...of Temporary Vault,$... . ...-:
: box: Up Opening of Grave or Tomb.........[. ---+--x
“Maiden Name of Mother. a= Liege es y, Lining Grave, $... Lowering Device, $... . ...-Her Birthplace..... CE<ACLA PABA.. Outlay for Shipping Charges. . NGG CU em ars . Sere ey
ee 1 $5 Si $3.5 ist,$... psd ° Metort Rrernsins to (2k aact vat.. . Ratt a eee ge hee eee re
Se cA & fe oe VA ZL Z Or Motor . CACNOtB) Peis ons plane S€rvice,$...}].-.--:
spe Size of Casket“. . &. & ye peat Reten wa Soe Telegr., Phone, Cable or Radio Charges..... ]..-.:
ee ’ Manufactured by. ecncntice: C1.Gear. — regen ais pawl Madsala. 4 greenies eats b oem ae eae
Bape’ t of town Undertaker’s Charges....... . ..---:
rn. Acker He ig. { Sn Om Unite hare P.
ig Lot Now. Pearce: Coe ae cae ea TER a bake yoo eM 258 :
EIGN “us Grave No. Sane ‘. 5 eta) Total Booting of BiR 8a $1.3 72).
e[ ax. 7 coe ns 0 Spon ear : a . oy Section No ee beet eee rere gH.. 7%
1 SS ee ; Balam.. yes, $2 54.
Diagram of Lot or Vault OWNER. oe eee et eee Entered into Ledger, page.. ..or below.
! re ae ig =e q as . . 1