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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
4 == ss RECORD OF FUNERAL
Dates Peebeel soft cwvasnen’ 19.46
rela weanreates Re RCO rahe aaa en oe ie
(Busband[_]Wite[] widow t
eee ee oh Ree cialis sue where
Embalming Body ... 6.220. essere? eee cell eyes»
: (Name of Embalmer)
Barber, $....+-0+: Hair Dressing, $....-]}..-ial Security Number) . Dressing Body,$...-.-Underwear, $...-. . .--Name of Employer. X. Al. : A. CEs whe -] Suitor Dress...eeceeeece reece eeset tests rees
(Pp © : ' (State Kind and Color)
Address ..%.-¥dssee eee te Slippers, $....+++:+ HOs6,) Scere 55 ales fo Socom
Folding Chairs, $.... Tarpaulin, $...---l. ---AMSA ?
Pata of Date A ct Ss “"(Date) (How) . Candelabrum, $.... Candles, $....++-. ---Date of Birth. “YY. 7 a epee re nnle ¢ J ei, Waele .{ Door Spray, $ ..--++++ ea, A eS iN . a
Lee, Z 14 _. Funeral Car, $...--Ambulance, $....-. . ---dicted sheds ivan oa (Most) Di “‘. :Limousines to Cemetery ... A ES eae aes
Date of Funeral.....00sdins onnc nt eee ste tlewcesees u_. Autos to R. R. Station. ...-@$..-eres fees
(Date) (Day of Week) Cou) “Getting Remains from....-.+.+seeeeee seeders
Services at prov. Ro cy ag ; prog sentence eee n ees ‘Taking Remains to.....seeeeeeeeee reer cfs ees
I arorn. ae ae ____. . Srip.to Coroner’s Inquest ..,++++++eeeere refers
oc tia land a iat so Pt A aie Delivering Box to....Re cast dee,
Religion of the D ased. cle bb p60 80 8 eels 06 066s see : aw ales © Deliver Flowers Fy nts atch sel cle aaiwee ecevece 9 eiencoes. ladena
iii, Leeman beh le _. Gakef,.., . Removal Charges...-+sseeseererrrerscre ers:
oe = Procuring Burial Permit.. 032s; puuiat spo
¥ (State Number and District)
Ui ;
Resided in the State.... mags Len) ee Rae
or U. 8. or City or County) . (Yqars) (Months).
Burial Vault or Box ...---2eeeeee eer res
(State Kind)
___Certif.Copiesof Death CertificatesNo
ee
eee Ce
oeele
seals
ecelere
( .
: y Physician’s or Coroner's
Place of Death. A1lv F aii, A Pall Bearer Service, $. Use of Chapel, $. ap, Peer
Be eee a was Personal Service. ..+-++0++serserserresr eres nua ae
Contributory an I od a pigs acs asa RATE Ae Oe As = Hinde’) 6 nig Re (mE nS 3 Be
Lath. cm 'WGross Total for Sales Tax....0:s0eeeeees $l].. 4.0. s
i aod ioe Outlay for Lott ..... ccc ee eee eee e eee elfer cere ees
wip siamese Cremation ....cccccc cece ect e ere ete eee eee eee e efor
..line Death Notices in... Papers ....])----++].
Bg ina 9 Ee a a . et
Flowers, $... ; Palms, $ : aoe Matting, Sh ool, pas aaelbaes
His Birthplace.. el, CLES Rental of Tent, $..of Temporary Vault,$... . .---++. ->
. Uorh erniecectre Opening of Grave or Tomb....--..e eee effeere eee]
Maiden Name of Mot sa aha ae Lining Grave, $... Lowering Device, $... ].----+++. -Her Birthplace.. “%. Eh AGE AS gs ale lasers “ats Outlay for Shipping Charges. ....--++e+eeelersereefee
: Clergyman,$... Singers,$..Organist,$...]. .---+-. -Sip} Remains to. 207% Lhe Lk, viele eatiened us Pe Pige < ae $
: Hae re oe iroad rickets, Dies a wa'eg plane Service,$...\Je++++e}+>
Size of Casket. . . << I¥vtv [REIS EE REE OE tae Telegr., Phone, Cable or Radio Charges..... J-++++++. Manufactured by J cvarmszrde,. OAL, Gf.. Go. . Cash Advanced... see secre ersten eee ee eader sree ete:
A fnrord Cette . Cemetery) Out of town Undertaker’s Charges....++++-leseeee]>:
Interment at. Born gecarevidde SO ts WR on fucbeg clei ode dun Gib bo wlegiss sanek pees h oan
Lot No. .sseseeesssessesf Behe Vinee «falta eee
Qeadablen cei onset Total Footing wis UE ne a ee $75.9].
Pe POE De a re) Re a 7
‘ Section No....sseeee0+: 7 . . == 2
— . wen Balance.....-.-$. . 2%. .2. .
"Diagram of Lot or Vault Owner. ...-eeeeeeeeees Entered into Ledger, page... or below. ,
r . Amount Paid . Bala: