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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

Name of Deceased // i ee
Residence. ¢/A@4d Uabley L8t, Caring Ray oe 3 Cas WueLImow) , eben Wie ~ ORRCelecee
Charge to:
a Sat) PE OHS OREN OVE a SL a SSNS! a) 5S GOs: arene. scmierel Wiel sieal a w.4) ae wae Bik Complete Furiéral cA" Sianeli $ fs a Gg ag
pi eile eae cr edo ea Casket..... MONI, reece eeeec call edb . € 0
Order given by......... ttt tt te eee ewes seen eens Burial Vault or Box.....00..c0.0.004)00 0 fo
(or informant) (State Kind)
How Secured.. U MOM. eee ccc eccee cece, Embalming Body ......0.0...00.c0Ieece cele.
=.
oe (Name of Embalmer)
i Occupation ..(L¢. A PPO Be ud ois Codec Late et Barber, $...... Hair Dressing, $....]1..../...
Athen (Social Security Number) . Dressing Body, $..... Underwear,$...]]..../...
. Name of Employer. . CAARIM. ele. ci mle ijeleear ee ee ee ees LT ol
} 1 tate Kind an jor.
Address SOSH CRSA ERIS 0) 6 SEs 0 SER nies 6, ole.0.d\0'@. 0.4 ee uavere Ment bars oll vate Slippers, $ “jor ie ees ae Hose, ee a a pe,
Date of Death. Puty.. PS 3 © Gm Folding Chairs, $.... Tarpaulin, $.....]f....)0..,
(Date) (Hour) Candelabrum, $.... Candles, $......)......
Date of Birth. 7727.. Pilhcidhao odin cane 8.4.2.. Door Spray, $.:.... Gloves, $..... ar ae Paes Bi
/? ..{ Funeral Car, $... «oAmbulanee, $2. 0.66.5 .l. 00. es elees es
BBP == ono 73, 55 ~~. iy he ph ee (Days) """* “"* ". Limousines to Cemetery. 5. -@ $..cceeeeal.cs.cleece,
{ Date of Funeral Lunt uly G A eter svt.. £36.. 0m. Autos to R. R. Station .:;... ON ee se . anaes Meee
aan J ten Weeks om. nertoun) Getting Remains from. ..).......0..11... fl,
Services at: errs : ee ane es A.. Taming Remains tog oi ts i cdc We Wee cle
OT Vig Trip to Coroner’s Inquest..+....0.00000.0 . ,
lergyman: :.2.¢ta.. 7#awtk. B ie a nie q ae :
e c : a ? ~TAdaress) / . Delivering Box toss.. 6.6 eeeeeeeeeee ee)
Religion of the Deceased.. 2omvehow oo.. ce ceec eee, Deliver POWO 28) Rica oss vais vs coadaty cole teed
Birthplace.. OT irion. der Se Lae! ame aa Heh aseeuy PROMOVELORMIROR Dis 5 int aserlscssuinvidlce tlt
G6 : Procuring Burial Permit...........)) 00000 000
Resided in the State...........99..0 0 a (State Number and District)
(or U.S. or City or County) (Years) (Months) . ___Certif. Copiesof Death CertificatesNo.
Place of Death. Airadd
; hysician’s or Coroner's) i) ee
Lakley 13.) Money BON... Pall Bearer Service, $. “taut trace, .
Causcof Death.. Pa tikil Popnonal BOTW 3 cbes ees asada ven vw sods
see wens
SC Se CM 6 2.6 60.0 0.6 6.6 Se
MRT Diet TRESS 9) 8 ig OB 9 <6 Siatiel ome G: ST ele iy) elelg «es fac) ald eno e
Contributory Causes..... PARR a Pel ay Aly mala tha tacts Ante ngs 06s ocniy vile ax Wele.clegn asco M®, Loe bo Sort
ea tip at Nghe Gross Total for Sales Tax..........$]].. 0d. aM:
ant y COMES TOOL hast sores cst ak. a du ee
Certifying Physician.\.%/. Cremation.... een, Fe NT Pmt 5 inet Gy ML
His Address. ; AT Odd. VaR: ..line Death Notices in... Papen ss scll cece does c
i aeoks Seeks wee EOS Ca ae aE Le . Rn yi,
Name of Father. fection ae a ee Sn ha =e Flowers, $... Palms, ae Matting, $...]..../...
Rental of Tent, $..of Temporary Vault,$..]..../...
Opening of Grave or Tomb...... SR: vege: lara as deal toca: , UO
Lining Grave, $... Lowering Device, $...]].... ...
Outlay for Shipping ares i in, ons Teen ok,
Clergyman, $$7%7. Singers, $5", Organist,$... AGL OS
wed Mod \ Tickets, $.... planes Service,$... ....1.0..
. Ghee Colca Naas Te Telegr., Phone, Cable or Radio Charges....]]....]...
Manufactured by Marks. CAM oe. Cash Advanced....0.00.0.00000000.0 100
; cst Out of town Undertaker’s Oi RO ties eee] ee 2
Interment at.. C49.. Cometorey, ay Be orweiiats et Vg
Lot NO.. oss. eeeeeeee ee. Sales Tax Pee Nr ills Ciao aml ee tia ees eee
Grave No.... tale, Total Footing of Bill... Seeeee eos yee $I Flot ¥.
. DARN OY BM ae sie os bass soeei casi ony ieee ot eailberaehs of
Section No..... AREAS $ —. ——
— eo
Balance elle . 08% 9) 2 wee se $ nee Riale eos mien ace
Diagram of Lot or Vault PME Sli. seg lend cle Entered into Ledger, page... or below.
Date Amount Paid Balance Date . Amount Paid Balance
. mm. AL > + . . i meen Ts r >