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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 tg Yearly Nose. osc i. cate tees Date.. a oe § td. :
eseee
R bea Age . t Baakate
Charge to:$
Ui jp 7 cee oh pe e249,
Address, . Wa.. : pes . .
cei 0 acoadad .. ial Vault or Box . 800-0 tescssofecse
fp UES Embalmi Bod (State Kind)
How Seeured..: .., Sab GAtE on os se bbe cob onc caws mbaiming Body ... es sacar Nakina os . nia .
Occupation Cpt, I Ore ra" SN te Barber, $...... Hairressing, $....l}.... .
. Wocial Security Nember) . Dressing Body, $..... Jnderwear,$...)..2.4.,
Name of Employer.....€0. 0.0.0. 0000sseeeeeeeeees Suit or Dress.. 2. 0.9.53, pn Bi eke Pik eee
(State Kind and Color)
PRIMI go ca Sle a og eae as gammy, oar e eenighl © ghee Slippers, $....... Hose, $...:. MIS PE eat ‘¢
Date of Death. OA 6m Sa 2 /. 1 fKC 4 Folding Chairs, $.... Tarpaulin, $2.. 0.. ues ss
na fate) (Hour) ” Candelabrum, Bi es SCANS ae cs ee ae date Re
Date of Birth. i oe a me pie Pt eae Door Spray, $.:.... SPONGE, Wik Povey iat Bos a eee aks
Funeral Car, $.... Ambulance, $.....]].... oe
sigh eo FE Mr ehige (Months) "" ” Ti ZR Saar, ea athens to Cemetery... = i a RR een NEVER aD mh:
+i Ante OF VMN Is dat GOs cadet Cla dee . Autos to R. R. Station. ... MD Sie tans Bae v9'osera Weaate basse! ord Getting Remains from........0¢s0e0sHe wee. *
Services at +f Weng emaing G0. os ck cs asc vc fees Segue ‘tp
Clergyman: ALA gee Like Be slg nmi i Trip to Coroner’s Inquest ........2--]].. 0.. .
Deaevewingy THOR G55. ire a. 6 oe aoe wade Sa Gown
Deliver Flowers to.....cccscccuccceeees
Removal [email protected]. 60.. 0. isccteucseee cau
Procuring Burial Permit...........
te Number and District)
——Certif.Copiesof Death CartifientesNo
(State Physician’s or Coroner's )
Personal Service EET ONS Sari ah . ee it li Ee NN
Oe O50 © 0 ORO:e O) Rie ORAS e) SO 4 Oe 00 o 0.06 0O 0G 0 60 © CREW ieee 0.0 oP: c ie ¢ eles
Pall Bearer Service, $. . + Use of ae Pe 2 atest my
A SeF OBO 0) Fe OS) 000 MO ONG 60 e 0-8 RS ei) w O10 o. O08 0 8-4 So 6) o eiibe ele ene eke <
Gross Total for Sales Tax.......... $l.. PIS
Outlay for Lot.... fcketiesaitay, Piva aces occa eae . as oot aan as
Centtying P nvscian La A * of CRMMARION UO Fs S Se alist 2 Sepa
His A Biles : . line Death Notices i es PRM Papers’.. oo. sees
Name of FaéHer.. //. Flowers, $... Palms, $. Matting, $° ea ee, Ls
His Birthplace. <. ofp, car Pears mS as Rental of Tent, $..of Temporary Vault,$... . .... ae
Opening of Grave or Tomb.........].... a
Maiden Name of vg ae oe ‘T Lining Grave, $..:.Lowering Device, eee . e Os
Her Birthplace. .. CA0A2GOALOSUAT 8. oven eee. Outlay for Shipping , fa eee apy! Smee wi
Motor}: Remains to Ficoamatanil, ee: _ . Gesyman, $F: PaSingers $25 "Organist§ ee [oc2ale
Railroad Aer 2G ee S Gg Oe IID oe , road \iicketa $. 20aoe $20.3 )6 plane © Service,$. nla ecatelavais acer ohe os
_ Size of Casket %/ Le bf, (lads om Phone, Cable or Radio Charges E :
. ‘Manufactured by <A eaenamela Cr. aes Cash Advanced, . 2.6.. Ce dat ee ae “8
Out of town Undertaker’s Charges. ......J)--+++. <
“nement at. Leceacretieel Ceara { Seng OH ot mn Under Gara. 00
— Z Bt eae ees 52 pare tr te i, fe Cele ares, erm ele Re es
Lot No.. ...0eeeeeeee: SMO FRM hi) ees co cout eee Le ee —
Grave Noises. kecs ceo Total Footing of Bill..:..5....... $4. O77. . ! F
me ee OS, 4 MURS so s-scatel ara alle ce cea . lois ose es ob 17\4
. Section No.... os aia oaecaeeee Shr} eee y es
Dilan of Sek 06 Vani Owner. .oe <5 tee te sce Entered into iedere, page. .’. :::or below.