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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
278 RECORD OF FUNERAL
Total No... caida ae 0) Yearly No.:.....000SE Piste.. LP nc Fo v ede isc viens 1
Name of Deceased. . 1 tea.. PPte aa. G WPI Gs 6 aids Fo caw ons + Os Siem asin (LAA. w 60.
0 Ba an Single Aisdowed CF Divorcea (What Race)
eee eee Residence. LB rs Yio Zz Zeid. SH Divi er Gee tuk iim ae see vace Be
Oar i Be Laan ts
hadreea. 22. Lopate. i ane omplete NCTE ooo ince ewe 68 owl ait © 6,000 : AA
‘ Casket.. ALA CAMICE. 0 oo cece eee REL.
mage tee eeeees Burial Vault or Box ..Y0...c.20-: Sai yes es Ree! :
(State Kind)
How aereeee. LZ. 14 ogg! Gisele sega BEimbalming Body.. <c. <s.dsis ac=o < soph de ee Res ;
: (Name of Embalmer)
okiuete CLLAT . CPAMLAEA oo cece Barber, $ We ee ceeesees Hair Dressing, $ owe «<2 ele Me * + luis‘ ‘
Social Security Number) . Dressing Body,$..... Underwear, CEs: tttleal ie
Name of Employer. .777...eeeeeee sees eeeeee eens Suit oF Dea, fe tis. 0s oo edon ere hoe oe Hs MBs ets 32
(State Kind and Color)
PIE a Sosa ng COCR Es dis Gsle dp yee oe 50 ale ante mr akn anes Slippers, $....... Woes © eu cas sauce iota
Date of Death + 2 ET 09 — S00 po Ml. Aiser = pace es ie ee a Se
elabrum, $.... BION, Bin. ois oles ee oes
Date of Birth. . ers ae icles Door Spray, $..... Glove $4 6.5 dk
a Funeral Car, $.... Ambulance, $..... [.... ,
ab ap BE. eet oO is eas = pas feablane Limousines to ee Bohl F OE hn ace ei ae .
‘Date of pay . Yer 29a loge ro oe ee . Autos to R. R. Station. S@Wiks 2og.5 Pe ss.
(Date) difare Week) og Getting Remains from: .......+.0+--FA . eee ;
_ Services a Aigeperas EEE CTRGIETE oo +o Taking Remains to.>... ye iris fu we Bone ose See's
Clergyman. LE, pe Trip to Coroner’s Inquest .....325.2----.ff..5.f
x a Delivering Box to........ eee SY Siegen i
Religion of the Dee 0 0 oe ot WG ne ee ie Deliver Flowers to “eo et ion BOG
ee ee . ns i
, Birthplace en CEE Removal Charges osew ee To er ip lelldeere 6a Mcteed awe s :
; ‘ Procuring Burial due wee + eaille &swee's
Resided m thee : —Certif.Copiesof Death CertiticatceNo. <——. . -+--+}
Place of Death 4 Of Lida Lo fad. Pall Bearer Service,$.. Use of Chapel, $... ....
Cause of D th oe Caan 8. deltas Personal Service. oe ee ecees pe Ei Wire Sie isle aieren a) wee dale wt iste 4
ee es . oe
a, SaaS PEM a Ri ates ei Nea, oan of Dae Reet Ron adi ty Rarer Gross Total for Sales Tax ewe a he ae aes
: Outla COR BAe oa is in an ws ih Fa aL Se . . Ad eae A :
Certifying Physician. Laat, Peal a : Cremation GA ons TUR ORG 5 en Pere Blas, are
_ His Address. Li Fatih. . -line Death Notices in...Papers ....J[-..+.
oe . settee tteteree gcse se ecesec serene teeseenee dec sc es
. . Name of Fat 4 iE i ‘2gdat2 Flowers, $.. as} Matting, = SoM, Speers
His Birthplace. . Mbox 4, OA CoE A NUR Rental of Tent, $~=.of Temporary Vault, $ >:*. . ...-. :
: toon, Opening of Grave or TOD os Lait hay Sine ett
é Maiden Name of Moth 5 Led haath oe Cate Lining Grave, $...= Lowering Device, $...i}}---+-.“Her Birthplace. .. 447 fF 5 Ee eee Outlay for Shipping Charges:... tae A ek,
meee Renckan to diene, Clergyman,$..\. Singers,$ <-erate, + Sa ae 4
: , of.. or Morr }Tickets, : + oe a > plane.’ ero Gervice $* acest“ § = lee sos
ee. Size of CasketV... AM abjade Ylocodt...\ Telegr., Phone Cable Dr RaaierChbizes™: we “o fe te , Cable or Radio’Charges *v>. Fry}..
> . Manufactured by; -4 aha. La I a Cash Advanced .-:. ey :
iE Che Lom etery. Out ¢ of town : Undertaker’ 's
’ Interment at 4 are le 4 oom Creates
Diagram of Lot or Vault
7