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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
AP eRe hae GP Vem ye Date. Adc.. 6.3
Name of Deceased../. agg . Ce haggteedle, LE CALEY. ve MOA cca, “ed uan cir srallg wha o-st ease Geers ZEEE oa
"Married Single Widowed Divorced (What Race)
Residence. 2.7 ./. p Bige Fy aktradn pea 5
Charge to: . Zo. pe ia edad eae eee Raa
ee er
a eee 539.
‘Midi! OO ale ete add . OO as ‘
; ape? ase Casket... st Br: PIPE P caiNees cake ce FAZ. «
Order given by. tA THT, oo ee eee ee Birial Vanleor BOX. . ca silp ace cathes vine Hele culls 4 sere oie
; (or informant) (State Kind)
How Secured. ~.. AZ. F iitooslavn wsbilles lien’, © other alts Embalming Body .....--. esses cece e cece eee ees :
(Name of Embalmer)
Occupation . . A¥or. Attu tfa.... iriteen sa Barber, Fee. sae Hair Dressing, $..... . .... ’
(Social Security Number) . Dressing Body, $.....Underwear,$.... ].... :
Name of Employer.. sic. .e sees ccc scenes ccewpecees an Sah te PR te ee eek ea dys ote FRE
"7" "" "" “State Kind and Color)
PERC eras bys o gates Wheto fope dl ereidn's toeoN@eele ola ceNGiS cel olen staxgie wraats Slippers, $......EE ieetats: SOULSe ;
Date of Death. Lick (7 te AL atep AfPolding Chairs, $.... Tarpaulin,$..... )..-.
(Dye (Hour) . Candelabrum, $.... CANOES Bike ce oi Wie leo tee ,
Date of Birth_¢4< CO Ee SD eee Door Spray, $..... Glave, Ge se ve.
ae — tes Funeral Car, $,.... Ambulance, $....-]].... :
te OO Care (Yeagy 7 Cia ys) cre Limousines to Cemetery.. . ee aes :
‘Date of Funeral. At. ZF, yA Tek "2508. Autos to R. R. Station. ...@$... er ch a :
~ diesel (Hour) Getting Remains from. ......06000e000s$ es cess :
ervices at. :/ SZ 4 : Z 2 fe , = AN. ZUCAULA KIAGER.. Wiline Pemeiig 0.6% ics. «suk wkGln sou te pect ees ;
Clersyman/Z247 Jew Piet Eke. ¢ aston ethane . nip to Conomer's Inquest. . oo. see. ose tees ep ce tk
er Protey Cris BOI soso 5 ov 9 oo divcateie wisitte wise ooolfas Bee .
_ Religion of the Deceased. . i ras a, Sal de Deliver Flowets 40.. .s0c-0. sence cseseus Ga aay
Birthplace _p a, $9224: eC. . Remitvah Charge. e saisiarWadiss ork ae he aubben eva ;
en ; Procuring Burial Permit. fae ns os Die Re aera ‘
Resided in the State.. 5 7 7 Otey on 6 Charny ”“Cveats)’ " (Months) '. —_Certif.Copiesof Death CertificatesNo. Fe eel =
(State Physician’s or Coroner's.)
Place of Shan tes ALAC nw vce ce ec cenes Pall Bearer Service, $.. Use of Chapel, $... . .... :
Cause of Deatt’: Ae ge aang (Ei lcaee ae Personal Service..... sane test sheng i) Sapeets ‘
Petes 7 eee As aL rg a erases hat 6 Pe octane eihners O50 Sate soe Panes ena :
Hteipacapforeda Chad: , z-44-<2..\ Gross Total for Sales Tax........-05SS het
rn pe fOr ELIS FOR TANG ies cas oar a ee aght, osol aiet wate. aca glauca ede oath on ;
Certifying Physician. . TF NOMI ce oe ee gate eer ics «key ees Mees .
Wis Addveu. 0-3 , , ..line Death Notices in... Papers .... . ...:
Sg he. 66) ee 60,69 OO-6)-0 8 Te einen Ot News fee ee eee ee ewww ee ee wtier er eee # ete
Name of Fathér. oft ots Lhoerthata. --+. Flowers, $.. Sams, $ egy ¢...1 ae
His Birthplace.. ICY: ee aes . Rental of Tent, $..of Temporary Vault,$... . ....
; . Opening of Grave or Tomb.........][.----5;
opin Name of er ee Agsaegel:. Lining Grave, $... Lowering Device, $... }...-f
Her Birthplace... 7 “ A Le sabres ocsietltals Outlay for Shipping Charges. ........]}.--.-d
Motor} Resin ts. (egos om Raed ic ae Singers,$. -, + Organist, Bc GA wued Bae :
a : a5 Hatred \rickets, $.02.1. Service,$... }.... .
Size of Casket, 742 P28. AL bpered, ltelal. L. Telegr, Phone, Cable or Radio Charges We sk
(State N ) -s ? ) UNATZES. 2.2. err eeres .
Manufactured by: : tocaoeelt hah . Ee See a eee ‘ Pt Nae Altes leit tae eee effe ee eeee :
ut of town Undertaker’s Charges....... [--++++:.
Interment t. Aaaarrene. Chrverlacg. . Site ners meme, te Pee MMi aoa, “Saas ee
Lot Nowe ceeseseeeeceee] ie OEY ae ameter pe SE
Grave Nou. 2.ccerseeesie: Total Footing of Bill.........055$F F.9. ,
; ; DORs ois a ae oo WO She elete Grae Np iw #86 6 0.6» 8 01a e106 4 a ag ©
Section No..... mata saat sant hohe ler ; $ ae
' 1 ama ; Balance Cows ccescccese $ SF 2F re
Diagram of Lot or Vault Owner. .--.--+++++e-+0-Entered into Ledger, page... or below. .