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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
oe eiek ee Soe
Woe assso ons cas aelee seit of
. Charge to:
MAD .\<KLEA ET, . 0..
28
gages Pe at foI Z,; 2 fie de ft Complete Funeral ....---aa 7 $. . _ 2EF.
Casket.... EL yatta. oe eee eee 275.
Order given by.
Burial Vault or Box ..-.---segerr ett Cas are
(State Kind)
How Secured...4.<H%
Embalming Body ...--:see stresses
: :
.
(Name of Embalmer)
Occupation ...“ 774.4
Barber, $.....-+ Hair Dressing, $..----l]---+-+-Dressing Body, $...--+-Underwear,$...-].----Name of Employer...----sssseerrsrtrrsrse
att ch PCN os oa css dodo ie come ere en
(State Kind and Color)
MOONS hoi vn sao spp tase gue mae eee wnt nt ee Slippers, $...---++0+: Hose 8). oo ag eee
Date of Death..
“4x Folding Chairs, $.... Tarpaulin, $...----l]-----Candelabrum, $....-Candles, $...-+.++-]Peereee
Date of Birth. %. :
Door Spray, $..---++: Gloves, $. ss. 05-0000 ef ee ees
Age
Funeral Car, $.... Ambulance, $:...---l].--++>
eae
Limousines to Cemetery...IO Sorceeks eee ae
Date of Funeral
. Autos to R. R. Station. ..-@ Be cac seve dee eess
;
. Getting Remains from...----++++rererre
cfr:
Services at ,/
. Taking Remains to....+-seeeeee erences edferres
Clergyma’
22 Mea Trip to Coroner’s Inquest ..--.-++++ereerrcffereres
“4 ee
‘Delivering Box t0.....secerecesrsesee
sires:
Religion of the Deceased. /<2 GEC FAW Ket. «++ seer ees Deliver Flowers to....seeeceereerereet
referees
Birthplace .
Behr a Removal Charges....s-ceseeseececser
tte spereee:
Resided in th
Procuring Burial Permit. pO cree ge ne
eae in esi State. & or . OF pee
) Capes ___Certif. Copiesof ag oy
BU ite
_ Place of rae DS GGA Nb lel. Pia vee Pall Bearer Service, $. “Use of Chapel, $. ot a) eae
Cause of Death: . .<
Personal Service...-Sr be Rien etal
Contributory rca cs tc cee rales Lath prise Sar emer ees en regs SNe te ee
SE ree Phe icin ts Caamalenaeks aor Crna Gross Total for Sales Tax....-.+2+0+00+-8).
0-4
Outlay for Lots.. ee ne oe eee ee ot
Certifying Physician. eos ite
Cremation i oscnccceecece esses recess en beee ite ss:
His Address. :
_..Jine Death Notices in... Papers .... }.---Name of Father
Flowers, $... ; Palms, $. . Matting, Sapa Cee
His Birthplace...#%.-Rental of Tent, $..of Temporary Vault, ee ree
oe
Opening of Grave or Morne ol aes sacle ve we pee eee
Maiden Name of Mother
Lining Grave, $..-Lowering Device, eee, ae
Her Birthplace...--5--.°%4
Outlay for Shipping Charges. ...---++--+-+-[Po5:
M Motor} Retaains tc.
Clergyman, #2 “A Singers,$. . » Organist, eee a Po
43 See
Hi Rairoad \ Tickets, : See pinne o Service,$... . ----Bice. cheat
(State Color and
.---. Telegr., Phone, Cable or Radio Charges..--+--. }-+>:
,. Cash Advanced ee feat sl cats ueleretees . Bapee
. Out of town Undertaker’s Charges...-----Deas
!
Tot ees 2G Pe $25
se eseeeeeeeee $l.. 4
= ae ES ; .
a a ee $ ey Z.
Diagram of Lot or Vault ob ae, Owner . weet cere eee wee eeee
or below.
Date .
. Amount Paid
Amount Paid ie