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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 FUNEKAL
Residence. .
oe es
Date.
Ble eral ole Le POEs eC ESP het ee sece ens et
a eakds Sk EEAA ee ED, Pactonee ibb doll Pareiticeyerreet S28, 2 eee: SMS OS ee Oe
of
Charge to. ak fe
Address. , Sn iA’. fgtene Mbvaad ener =
Order given by... Bad oced
Hd Secured... A fuexk
a hana cil ie ou teats
(Social Security Number)
Bie lee O26 0.65 2 OS ROSS Bee & Be
Se) BLO ee ELS Elec b Se M.S ORES, F
Occupation
Name of Employer
: SA iivege, ci ttadet gg be aertes tans et Veen tame ee +:
+ ~Date of Death.. ED BARE.. CIF (Hour)
Ug) a iehkib sib wi. tine reel Whore! ,6 Ores @ yer ea ene rire es Pee te ieee Frit at Fe
“Date of Funeral WZ. a (cl fg am 4,
Services at. De cgont te EF
Clergyman. Uke: a
Religion of the Deceased. . tis ease
Birthplace ../&
Resided i in the State.....722EL:.--et
or U,S. or City, County)
Place of Death. Jie leck rT
(Address)
eee ereeeseeoeseees
re
weeeeereere
Pee Pe a
bsFolding Chairs, $
‘. Getting Remains from Haryaarlle Pe ei
SS Se =
Casket.. % +. DeAarter
Burial Vault or Box ..-----sreccssee
ttt
Embalming Body Dgget: eae NN
(Name of Embalmer)
Hair Dressing, $...-ce Sai eae Underwear, $...Suit or DresS... cece eee eects eet
(State Kind and Color)
Hose, $
Tarpaulin, $....Candles, $
aa Ee ee ae Te ldaee siren] . (el aa
Slippers, $
cc we oe HAR PAUIil, De eee eres ciieecer®
Candelabrum, $
Door Spray, $
Funeral Car, $
Limousines to Cemetery @ $
Autos to R. R. Station. ... @$
Sew eho oc Ce NONE Mey MP Rees ay ee ge oe SRS, Sym ee See
re ee ee .
ons eo
Taking Remains to
Trip to Coroner’s Inquest
Delivering Box to
Deliver Flowers to
Removal Charges
Procuring Burial Permit...-..--.--:-++:
tate Number and District)
___Certif.Copiesof Death CertificatesNo. ae
(State Physician’s or Coroner's,
. Use of Chapel, $
ML, wie "SiS loie ehaysls-e ele ee. ois me oe em) t
Gos Die -a (eRe tetera SS tae 6: Sue) ©7918, (es. e hs
o eee ee pe s.0 5 9 W © elle e ANS 2) 8) exe
Bes. alalece 6. ¥epeje #0 ce lee a) si) len-enigve fe (ele/(s Ese) 6:6 8:
se salted Ore WTO LONe 8) 60 e050 2B) s fae, Ee: 0°68)»
eg Se eLele eretes fC &.0 V S8956 1G. 0 Pi SE P<
Pall Bearer Service, $. .
Personal Service
EL WEdes gata e congo ie OHal, Se pane rare O16 56 5G! 9h, OP SNE e) STeneT eS. Foe.
gid be Raa Parte OR LOW We Se & Rie scene RORY ee See ee Ne AN A RT
Gross Total for Sales Tax
Outlay for Lot
..line Dea
Siete Sr aHe SOS Oo a eUvEe, Ws STORES ©) 96 9
fete: gai iep ecm e inte Ee DA eee ole) mcle 6, FBP: 2 Ba%
fe bsee egg Sen E RL DER TOM 16 SS wE Re we Ole kag Wree Fei soer cl ae
ames of News
Flowers, $ Gigotii on Matting, $
Rental of Tent, $..of Temporary Vault,$..
Opening of Grave or Tomb
Lining Grave, $ Lowering Device, $ a
Outlay for Shipping Chareee scale sons Coa es Sa ses
. Clergyman, $4.5. =? Singers,$.. .Organist,$
t eof conte eit Color and a 4 Lf 7) cr
—
Railroad
or iiroad } Tickets, $ AcroService,$
Telegr., Phone, aw or Radio Charges
Cash Advanced: .
ee ee
a a
Sik po lee © Side e o) eee! ©, 670, he 6+ 6) 0,6 (6 0) Ole (0:0 6, 0 6 WS e Spe es
re ee ee
ee ee cee ese eee ee eee eres
wee meee eee ee eee eet sewer eseseeeeseeere
ee eT
eee eee
. Amannt DaiA . Balan f . v Date iz *: