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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

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a .
es RECORD OF FUNERAL _
TOGO, obs yids ce eee Yearly No...... state, ca be Date. .@ oe) po Me ie ¢ 1¢
Name of Piscenas os Uaelaecck. ie =: aE Shite de..
0) Married DO Single DD Widowed D Divorced (What Race)
Residence. . x ile TOS Gem geS ac? eee cat, a te mar uaetameedvety ies eg ne
Charge to: fotwo. At.. Meith. Creda etnies wiles ee eeu ren peewmem Saree
wsdergZ.5., Te Mile ee eh Gre. Complete Funeral . wncaininninnnececans” * ** el el ee, AS
Seay sh four > ag bes Cf \ cig eee ge Casket¢oq LCA AACR. oo ccc cece ceeeee FEE
Order given by eee Tag wre Birial Vault-or Box. ee ce
(or inf ant) (State Kind)
How Secured. . “ZZ. get Uh he ape eet Pp Ee Embalming Body ... pecans wea i je ergsssre . SME er brew
Oschipetion aces emir SE EAL CA-SFF (9. Barber, $...... Hair Dressing, $..... )..0..].
ial Security is ae Dressing Bod A 2 Seer ar Underwear,$...}}..../.
Name of Eewioyer Sears Sve Lowa ZIM suit or Dress i : NC Ae , EM imei cet iB
(State Kind and Color)
Address yee tele esi isigiwe eae © +s Slippers, $....... OM Oe ie eee Bie kes ks,
Date of Déath ret G2.. 224 FG Folding Chairs, $.... Tarpaulin, $.....]]....}.
(Date) (Hour) . Candelabrum, $.... Candien, $. oo. aisss Wes ccc ook
ate of Birth. 2G WAERZ,: Tee ee ee Door Spray, $.:.... Gloves, $k os classes ek.
. > ae po 2 Funeral Car, $... .Ambulance, $.....H....[.
uit z an Osi re, (Days) Limousines to Cemetery... WB iss ask ib wR Oe
Date of Funeral FE BY AF7..,2. Vig m. Autos to R. R. Station. ... See ex a als ow Sa cee
(Date) PAR (ont) Getting Remains from.. 2.6.. ces cael. ob.
service'nt Coleco oi bette eens Taking RARE TOd os is oc se ob Be
Clergyman: Sioa OF AY tlw be AV Trip to Coroner’s Inquest .........-.11....}.
ee Debvering Box t0. 0.50.00 ei poetic cecese Fas) Sree
Religion of the Deceased. Cheedn Zain tebe eeeees Deliver Flowers to. oi.. 0. 0o seas css ens sys: Aa hae
Birthplace sew Aid, ge. AG and. ..;. Removal Charges....... caida kvm el aa yeas
22 Oe yy, Procuring Burial Permit. lbs Ge laatieg SeubeT tir P=
Resided je: the State. (or U. Sor City or County) og ow ‘. __Certif. Copiesof ag (er eal Mena . ae Dares
cian’s or Coroner's
Place of Death: Lo ee cae mai Pall Bearer Service, $.. Use of Chapel, $... .... .
Cause of Death: <= Personal Service.........ccecceeee 2) eee .
Contributory Causes. 2%. orcs ey ef ‘ Z. SAREE Un Beis rea eM: ol alls ee
AeA. “/, Carbarnmaice. Gazceay Gross Total ies Denes Ti et ee $]. ... XI. 7.
IY Cfy2/72 OME BORER orice dea fd och oe a Bape ie = §
Certifying Phy (bh te aaed.” ne Cremation salieisigtaas < ie ee eae Dee ast Ee uf i
His Address: :. CBZ ae 2 ae ..-line Death Noticesin... Pape. 6 See: ee
Name of Fath gate ° 1 ag: a lowers 2: Palins, Fv Matting, § Soe Ue a es ee
His Birthplace.... . roy #2. MAE ec ceee, Rental of Tent, $..of Temporary Vault,$... . ....].
wes Opening of Grave or Tomb.........]]...-b.
Maiden Name of Mother.’/ ‘*"! Lining Grave, $... -Lowering Device, $...1]....}..
Her Birthplace. .... Outlay for Shipping Charges. .2.0..00...]0...0h.
eee} Bivins Clergyman,$... Singers,$..Organist,$... [.-...b.
"oe dont rickets, , Ae Acro Service,$... f....).
Size of Casket 3 . x : Telegr., Phone, Cable or Radio Charges.. 000i os
, Manufactured b Cash Advanced ©. (650, 0740-0 Bl ele/eiel bum 0-8: Bh¥ te 680.18 ees . es a
: Out of town Undertaker’s Charges....... ]....}..
Interment at. Fe SEIS SL Ree 85S LOMO Te MS SST Ure 6. oie 6-9) BNO CS lbh Bude. e Cele EY. ©) Bielece tabs c
sai gag Sera ae
Total Footing of Bill.....2,...000. 1.4/5.7
Sax. Joe sy ft .-. Less. 2.. wee BA cinncrtl. siigaiaten $}.7 A. Be
AE ae OEE spins wre Pighies s 5 -+-]. Entered into Ledger, page. . arecOr beloWren<. }.