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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
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‘uence oo poe as
Name of Deceased.. (BAARAA. _Lernhe Yilbuaane A
(0 Widowed
WW Single
0 Married
Date. Lenagasad eae aciass
.0. 0202s secre
Vearly Now..
a eee Sa
ae
ET
(What Race)
(0 Divorced
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Residence Geerkuapet
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sl 722
reese DY AGE
Funeral...-.-----eceeee
omplete
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F
Salis eagleBc idgtstitity tablet swe ac
earn cee . xte F.
Casket... ee 2 FIae
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Box...
or
Somes
Burial
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Address. . ge
Order given by.
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How Secured oo. 5. DAPI sie she eee ee Wess he BOOS oud (Name
of Embalmer)
$....-. .-.-.
Dressing,
Hair
$......
Barber,
see
welacisecs
Dette
ate
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Occupation. .. nF oi "tic
(Social Security Number) . Dressing Body, $....-Underwear,$.... }...
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Name of Employer. o.oo 5. co.uk a shies o oie cies Sole niente nie SOO Si
(State Kind and Color)
ee
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Slippers, $. 55..
en eee e ener reneesenen ee eeass
ee teen eee
Address.. vane
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DIAGKA.. Ce.5Y beet, Folding Chairs, $.... Tarpaulin, $<.. 26.0.
Date of Death.
Si afee ss
Candelabrum, $.... Candles, $002.25
(Hour)
ee
AR ee
ccc cece es Door Spray, $....Gloves, $. . 00.00
Date of Birth.. Meacare. Gir CIAL cece
Age.EA gig auc
Funeral Car, $....Ambulance, $..... . .-aeEeem ee!
“aeeee
eee Fie ipaeeve
Limousines to Cemetery... CPS 2 eee
Days)
4.J0 AOR M. Autos to R. R. Station. ... @ Sp
Date of Funeral.
Gettin Reninins (roms .5 56 220
Sa?
« Li Teh hat? 2
RS.
Services at. (. IU PRAT. N. ZR ABA . er FLAG
Clergymss.
.
ihe
A,
ste
Religion of the Deceased. . (<2:
pe
oe tag: Verne age
ck
Place of Death.
Delivering Gott..
‘Address
nae em arse ee tc, EMeien
c. ss bie soles ek seth sss
ae OC Deliver Flowers to....eecceeeeeeeeeeeceefeeeee
ies
adhere Preval teres on ck cate 2s ako leo fe en 6s
' Be anahn. ; Cattegaed . e
Birthplace
iy, ie ns Ae cos
Heese
Trip to Coroner’s Inquest .....---+eee
Checaratkl,.Yloadaraa....
tLe ar,
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vtiete:
Sa oie See elarette
Procuring Burial Permit. ssiand ieuttet ‘end bist’
‘
O0
Ze A oma iti") Cant Copiesof — GertifieatesNo——_]...
4 ffx:
aul
Caaseot Dcath
ae
ita
“—
ysician’s or
Coroner's .
Pall Bearer Service, $.. Use of Chapel, $... . ...
2
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cy Veda eatace a al b-side OM Santee Oe sips
Ms eer
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agaee 7; MRS
Contributory Cansee.Locterte. Ae
oe oe eat ES, os eR Te belgie. org Gross Total for Sales Tax........-4+eae
ONIN
Outlay fOr Ob
jg
Certifying Physician
PUNE
iia Addrecn.
eld
Ll
Name of Fath
bella $
or
Coroner
Gs Cremation
Mein
cas [fewes
..line Death Notices in... Papers..
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een 6 eh escheat
sods
A) Mena
.i.b oo.. cles fe SETS
eke a Pies oes acs Pag
ey coeierstecs pelea) Ugo
owers, $... Palms, $... Matting, $2.. .{k. 2
His Birthplace. . Meade, ite dk" elles ae taut Rental of Tent, $.. .of Temporary Vault, ; eae ner
Maiden Name of MotheSerban
Opening of Grave or Tomb.........
. Lining Grave, $... Lowering Device, $...
Outlay for Shipping Charges..
2.0.2 s5e-<-Sid anes» 92:aa
.Singers,$..Organist,$...
fast
‘ Her Birthplace. .
a} mp
_ iroad Wri cicets, ae, Flame Service,$...
Size of Casket 22.74.17. Lora Faclllhrck.. ‘. Telegr., Phone, Cable or Radio Charges
. Manufactured by. the
(State Color and
ae
g
A Coe.
Cash Advanced er
Cemetery
Diagram of Lot or Vault
PE
HO,
.
" . Amount Paid . Y ‘Balance
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ia
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