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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
eae OF FUNERAL.
HY) NOs: oo tic c.
oe
Residence : a oF, i es
saga we sie Date.. pr oy es
A lemgdiad: i Soe eet. GEE.
Widowed Divorced (What Race)
ae Seca
OP a ion Hikes eecasieiee¢ of
eowreee
Charge to: 47224. <G
Adarees. AFL LEG
Order given by..
How Secured.:...4<7.
Occupation.. %
‘. Complete Funeral. .... 2-2. sees ee eee eee $. . “72.1
Casket... SF . AD CAWAECHA. 0 cnn 1.92
Burial Vault or Box ra are ae a ee
er er ee
(Name of Embalmer)
Hair Dressing, $....
Dressing Body, $..... Underwear,$...
Watnc Of IBIDIGVERs o's; ai. cen he et denne hve eens Saree Tits eee oy oe me
AGERE Swen Foe ceases ete cevedse cess $e Se abies Cae Sate ry ne cee
Date of Death Ltt, a? Ae oe fA Folding Chairs, $.... Tarpaulin, $5. 5s.. +
(Date) (Hour) “. Candelabrum, $.... Candles, $......
Date of Birth.. % CB -LRAG . . outa . Door Soray, $ «5s. sass Gloves, $....200+Age nl AF, Funeral Car, $....Ambulance, $.....
; : Gat) Ox Limousines to Cemetery... OS. i caendie.
Date of Funeral JH, LOK !B. "BOM. Autos to R. R. Station. ... ecu!
of Week) ows) Getting Remains from.........-005Religion of ren
Birthplace . .4 77-4
Resided in the Sta
Place of Death.
Cause of Dea’
“..1 Taking Remains to
_.. Trip to Coroner’s Inquest
Removal Charges
-. Pall Bearer Service, $. .
re
ee cs
as Delivering Box to
Deliver Flowers to ee
ee
Procuring Burial Permit
te Number and District)
___Certif. Copiesof Death CertificatesNo.
(State Physician’s or Coroner's )
. Use of Ch apel, $
Personal Service. ... ccc ce cece eee eee e eee
Pe
Contributory Causes. et Aged Dee ese epee cae BL ata has orn aa dle. ait coer are say ash oe
Gross Total for Sales Tax.....,.-.)-++-a ee it
a
see eee ede
ieee 3
eee eee eee ee ee ee ere eee eee eeeseeeHeeeSeeeeeeeeeeeeeeee Outla for Lot 2 ene Khas Be. 25: ;
Certifying Physician. ‘ (Fkx2 AEA.. Creuiation LES Tid si vin 5 Ns sg PR Oe 4 RD oa 6 Ore
His Address. . ZGrend. G24, as Ae line Death Notices i (Te lest eh Papers .... f+. +].
Name of Father Beas! 5" ***. Flowers, $... Dams $s. aa, Matting, S. meeerae
His Birthplace. .“.... MILI AECTUPIT. 0.00.. Rental of Tent, $..of Temporary Vault,$..]}....1.
: Opening of Grave or Tomb.......... )----++Maiden Name of Mother.. 20-2005 AWA. wees Links Graver $i.. Caeine Device 8 sci 08 <n
Her Birthplace......4 < de A Outlay for Shipping Charoes. 0 3.4 int cosa ee ee
Motor} Wau oneinc Wi oe om Clergyman, ¥@, 7 2 Singers,$. ig: . Organist, S 2h. AQ).
‘ ‘“’ ve Ww Re Monr }Tickets, Bs sree « wiaca plane n” Service,$. . ¢.f-s +++ o+k
Size of Casket “¢. pice PS ila 4 -. Telegr., Phone, Cable or Radio Charges....}}-++ +++}:
Manufactured bv: "BUELL. fa cies CCRMIN PATRON 6 oe: oes Sa. on soi ses ois wo kG a ee oar
Out of town Undertaker’s Charges......]}.-++-inom a. Lave. Chr ned Say tom sees ams
Lat No..-sserieeeeesseesf Sch iat aaa. CE
Grave Bid.. rss es Total Footing of Billocj.s.. eee oss ece cawes$ re at ie
. mae LSE: 0 4 eeeetiene . een ee aoe ME NtLe. Section Noe. i: < os Ses ci00)ae
nein —— BNCE SS hiies cee eee
Diagram of Lotor Vault Owner a ee Entered into Ledger, page eons or below
Toto . . Amount Paid . Balance . ; Da ee . 3 ‘. i . Amount Paid . Bal: