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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
Total No.2? fel ~ Yearly No. Ep oan ee See ee Date adel.. Sc eT
Name of Deceased.. 4£2AateOSe LEV GFBEEC ccc cence ncneeegpeceees as Leh Bow JF OGs
o Single (0 Widowed 0 Divorced (What Race)
Residence. ee: o Sg ood aay Pearl i dels ares 2 ae aienageest aged vaky ylmeavime
CEs wvnwis et ces _« 0
Charge we Lice. Zoame Pa ita) Ue I mee re 1273
Address. . . itn Micctaad DML ate ee a wteccunles Contre mee so: —<—<—<—< sgh
i Los Casket.. igh C00 bed. 5. c cs cece seen. ARQ
Order given by. acter Licarria COTE worse eve sewecne es Burial Vault or Box ..--2.c-gageccetett cece
1 Tman'
. tate in
How Secured. ... ee eS GR ify ee emp etetr Panbaiming Body . i.. ov cr ncn ce oe bee ie aes
. (Name of Embalmer)
~ Occupation. . BPG. i et Cede ep nt ayant Barber, $...... Hair Dressing, $....]}...
: (Social Security Number) . Dressing Body,$..... Underwear,$.... . ...
Name of Employer re Level anes el edes wibioyanot neki era Cele wie nia ate Suit or Dress “2 (Shack Srna , AL. 5
(State Kind and Colt) **<<4F ~
PANT seo cd vncedenecewa cid bo a Hews poelieeeie tak Caceres Slippers, $....... ee eee Ree
Date of Death. eT ALE LR. 7/0AeF ding Chairs, $.... Tarpaulin, $. 2.0. fiaks.s
(Hour) . Candelabrum, $..... Candles; $0).5 fis. eck-lPowes «
Date of Birth. . es ieee * ORF oiceidle e488 64 Door Spray, $..... Gloves, $2.6 ova. ea ees
sak Funeral Car, $...'. Ambulance, $.....][...
2. oc PSI Pees ’ ’
vine Nahe Ze en aire Ee Months (Days) Limousines to Cemetery... OS. oaths a.
Date of Fune: ae a =e pier tea 2.70 ¢¢m,. Autos to R. R. Station. ... Qt wih ee
Paget Wess) (Hour) Getting Remains from.........--0e{. 0. ee
Services at. 1 Zhsa . Parsachs tee eeees Taking Remains toc.. iui. vices oe vine eclacdlfeas ose
Clergyman: : ar te i ZZ: oamee Wis AA1.. Trip to Coroner’s Inquest ........+--{)...
DGHVernouBOx (Oe oo ee Se os en ee lee
Religion of the Deceased. . i el Deliver Flowers to....c.cc cece e ccc ee cece elec e eee
Birthplace .. Gé eo ieee ae Removal Charges.... ONS PCRS Cea ee
nn : Procuring Burial Permit... ees Spees pa et vee
Remon ie Siete ae wii a iis] _CerttCopiesf Death CertificatesNo.— I..
Place of Death “Aten, TA ’ Pall Bearer Service, $. vse of Chapel, $. yt Aleta
Corisoat Deainleebrcerraeg Te ie Personal Service.... Ree (ee
Contributory CBRE etre = on en hea ee a ere need © eM Gots tigeoa (oar, Mire Staten oes oer ks i cee har
Pie On cen i es aie eed Gross Total for Sales Tax...00...0000. st
BZ : SCT gl 0) CARAS G Sa epee oO ieey UNE Reon oh
" Certifying Physician, og gee tees ee Ce eee ie hers, Sear
tie Address. Lp SPM ae . -line Death Notices in... Panerai. 0b. eae:
MAS fA a Gli d Moeeesay type
Name of Father. x Deore oi fo Flowers, $...Palms, $ "Matting, $... . ....
His Birthplace. .7...5. C4kctétaate... ee ese. Rental of Tent, $..of Temporary Vault,$... . ....
ee Oy Z Opening of Grave or OME oe go Tinted nn a we 208
__ Maiden Name of ver aca on : See ee ae Lining Grave, $... Lowering Device, TE Panrdes . SMe me
‘Her Birthplace..... athawd . separ Outlay for Shipping Charges. sagittis shee a 5 ep
sy % ergym S
Motor} Remains to. hd. Ke Siguwancese Clergy: an,$... -Singers,$2. Le reaniat, $2.41 5 oe
43 OF Co" oe . or iiroad rickets, $ $. aces eens plane Service,$ aie c/s sfbeip «es 97
Size of Casket 9 Lag er tage 2+:. Telegr., Phone, ‘Cable or Radio il Dis's cp cae eae oes
Manufactured by .<<C/. Cash Advanced. .. A win ds Sees nate 5 aidiaik'g ve Self oe wee
Interment at. .
eer a .
Diagram of Lot or Vault