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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 B UNERAL
Total No. As Ss rete Yearig Nos.. hu dee Date.. he EE 5s ae, FOS
Name of Deceased.. Weatireds GZ. 4 Bet. LE RGRD [ote eae he eae Spach. Jere
OO Marri “o Single oO Widowed CD Divorced (What Race)
~
Residence. 44 Z. ALLA. dtieet Piste Sleals se cae ae Peer opuk Phaserced es
? 7 es eee of .
Charge to: Gortactd S. CL aaretetrn
‘ue dress, 4. W275 Complete Funeral........0.0 0005. $1. AFG
‘ pe Pa he Casket. OEE. CE eae ee ergs. ieee Ae HAL
Order given by. C15 BAA ABAABEAPA eee, Burial Vault Gr Box.... 0.00.0. e.ce cee eiall one.
(or informant)
. (State Kind)
How Secured. eecee figs. e7@), 0 #08) Se bob e etele (6 oo 6 ietale Embalming Body see ee (Name ot Emi cee .) ba ed . ee ey
tee AE settee Barber, $ Dione OB e tome gh hbase Hair Dressing, $ mines, . Sir eur ar
Dressing Body, $..... Underwear,$...1]....
Name of Employ er. 2 ont Suit or Dress..... bicxichnating co cotafeee
Address . . . . (hire COAL eee ene eee Slippers, $...... 7 “Hoss, $. i si Ow Aen ee
Date of Dekh. Wee. Zo: 5 eS, ae _. Folding Chairs, $.... Tarpaulin, $.....1]....
(Date) (Hour) . Candelabrum, $.... Candles, $......1....
Date of Birth. Ake. Oe a Tide OM a Pies oi Door Spray, $..... AONE Be ek
Te ee es oe Funeral Car, $.... Ambulance, $.....])....
Be. EIT, nage “"" “ays) Limousines to Cemetery... Ge ee
ate of Funeral ie. 264 AL: bie Tp.. ire. 2b«.M. Autos to R. R. Station. ... OF sed Be
(Date) Day of Week) soe Getting Remains from...........]. 0..
_ Services at Aewgexa (Uda ‘*++--1 Taking Remains to
Sy BB) Si Oy O7 bP 1059) BS w 6 ew 2g) Wines: GAM . e el ce Cl wa Atco: te thea. gee . ee Trip to Coroner’s Inquest ..........]..
Address) PIO WORIRIE BOR 1655 ds Sea ee cece ach Be. ;
Religion of Aone Janta, le ee Deliver Flowers to
_ Birthplace.
SUCRE ke ENO. 5 cl Wee nc heey he ee ee (State Number and District) “]]""°*** *
f Resided in the State. . (or U.S. bow County) ” (¥egrs) * (Months) . __Certif. Copiesof Death Sais ANGNASERIE Soh ae fleet .
Place of Death Zen MG.. I ERE aN
(State Physician’s or Coroner’s } )
‘. Pall Bearer Service, $.. Use of Chapel, $...])....
Cause of Death Le. vt feet: eee Personal Service..... AA ee etch ener tee baleen eh :
= Contributory Caueee ALkinwt Cl ott Sere Re et Cates (= satanns Ve ech 1699) w teRnde. 6 e-w us leMaeicllg ale ote eee a ERO a
meek. atbeeime Fitzy Rt fy '2. Gross Total for Sales Tax........ ren ee AAS
.Mk = tlay f t
“0 rtifying Physician. Z4/,. ZZ. Outlay for Lo
‘ POMBO eal s un losses tales LL
Hes Adtrem. Lf faiee eae -. line Death Notices in...Papers ... . . . ..
* Name of Fath : ees pe AP 2
Be ee Te ae OL Oe Ph ate.y eie-ecs, Wiehe tee Me: & eis ola
iG (685 S07658).0. 6S: 10) ees) 080k
D niEtE nay a fatager ee petit al ees Rieue a a6-6. 66g =<» els bles ase aay sc ch Lk
~~ 7. sl Flowers, $:.. ; Palms, $7” Matting, $.../. .. gets .
His Biithiynce hese ez BPECKACL OF, CLS Rental of Tent, $.. .of Temporary Vault,$... . .... :
ee Mai on se of M a isi re Opening of Grave or Tomb......... . .. ous
be Lining Grave, $. >.. .Lowering Device, $.../}.... q
—tier fedieccake ep oe --. Outlay for Shipping Magee ee. eee a cc Legellits x
oo Clergyman, $ 3° 2¢. Singers,$ 7Z2Organist,$... vce BEL
eee: Remains to, o> . Railroad
os 8 sce es aA; al = eral Sar. ra Motor} Tickets, . See aoe Service,$...]/.... ¥
ee Size of Caske
; Daacedea,, Telegr., Phone. Cable c or Radio Charges..... . ....].
(State Content a Number. éi : 2 oem MA *AVAQIO UNarges....
-, Manufactured by. ~Carcyaeasctonder. C2. Bas. as eae WAIN Core baie din ds a da o be RS cscs 02 a
! +a . $f Cemetery) Out of town Indertaker’ Ch Bet on Pa ose up Ree cd: gal vi
Interment at. Gopnece Par Caaccctbeg{ Cemetery i. Se. & a . Es pos PUN} yy Seen es
ee ie a Ay Sate Ce ee Ree SN eIere!
Se Hge CGI eA eS Ae Se aeie Cae lbw She lel-w wisi, nvtdegiece 13
ct Bist =r. :..3], Dzala
, finto Ledger, pages ros. or helow
ip
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