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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

0 Divorced (What Race)
Residence. 4 vas, 7B ‘ aio eae bcd oar re oh ase Pa eee .
eeee ee
Order given by. etecn Burial Vault or Box ... Saretee Ao tall =e scales vanes an
intormani! ' te n
How Secured. :.. Chars eR . alg Embalming Body ... ‘eis dg wndksey® SAEs goes te fen
, i nN oh ot oi . Barber, $...... Hair Dressing, $....]]..../...
ON ary Bare See ee (Social Security Number) Dressing Body, $..... Underwear,$.... /....]...
Name of Employer.... 0000s seseeeeee eee eee tees eee e BOT OP DIGGER oc 5 ea aia Soh he a creas 4 Ss an safle ce thal s coe
—_—_(State Kind and Color)
Address.. TET te eee eee e neers eres renereseesnnenence Slippers, $ a tiny a Hose, $ eee cas, sealer ee
Hab of Death@ove eee bk LP Hoe 14,30 mJ] Folding Chairs, $.... Tarpaulin, $.....]]....]..0.
= (Date) (Hour) Candelabrum, $.... Candles, ‘Soc s5.6 Fo oc all ao wat. » abareaters'c
Date of Birth. G/ 3.2.2.. CMDR, vas salag sl Bweadhh Door Spray, $..... CloveiaSs sc Sh Aa oes
Age 7¢ / 3 Funeral Car, $.... Ambulance, $....,. ]....[.-..spd ees (Years) 77" "oy onths). 7 "4 (Days) Limousines to Cemetery... Sn tan cs cle ee
Date of Funeral. Jl 7.. Mohuaitr....: x. a .m. Autos to R. R. Station.... [OF ea Rea iin, . te ted ue Pera
(Date) (Day of Weék) (Hour) Getting Remains from...........-H...0cfeeeeee
Services at eA rsogoee. VL near, Za, OTe. JrtPalcing FORRNAINE G0) 05. ccn 9s so bs seo deny's obs de olhee nd nn va foie we
Clergyman. :.(a24iom.iher,. Lurene.. Trip to Coroner’s Inquest ......0.0.0e-o. cc. cc lew sees
‘Talkbes (Address) Delivering Box to.. ....ccceeeceecceececll. oo.. lecee ee
Religion of the Deceased ,.. 2720. ee ce cceeeeseeeeceees Deliver Flowers to...... fs Sivtle Gibg steer PLM hy wes «nee
} !
Birthplace ... jg ae i MO par ae ee Removal Charges yess occ vic cde awetle ¥ oe vaste aes Sales + ees
; . 7 Procuring Burial Permit. les Sab tcg Hepa «oped «ied ee oe
Fedsed in the Biate. (or U. Lr Gity or County) "(Years)" ( Mouths) —Certif.Copiesof Death CertificatesNo.______. ]....]...
ee . es ee ey
Gauss of Death Canvesteoverne. cide CnrcenepPerponaVService..... eee sal os ca
Contributory Cangesehuvea. Cbd. COMA iW he cnscnag «Aye inns cece fn vcuse 0. Pex,
/
hysician’s or Coroner's
Place of Death. ASAORM e. Medley A. AI, Pall Bearer Service, $. Use of Chapel, $. :
Gross Total for Sales Tax... ae Maly ark Sih aoe $i. .. (\8e%.
Oey 100 LOE cic ccleeie ey beet rvccgecbces:
Cremation
ce ee ae rd
BW Dire © 9 OS CR) © 4), © 9 10 (0, 0 jo Wb 0 6 6.0 6 6 60 HIP Ol 10s Aw we 0 elles
come roe rerees pall am sowbalies . ee eeees
Flowers, $... Palms, $... Matting, $...}}....]...
Rental of Tent, $..of Temporary Vault,$..
Opening of Grave or Tomb
es ee a er ey
ee . ee er ae
Lining Grave, $... Lowering Device, $..,. . ....]...
Her Birthplace.... Unargacnvscre Viueliagh steiner» ce", Outlay for Shipping Charges. ......... ).cce.0c. eeeeee
; ae Cler, AN, $. 6.5% Singers,$..Organist,$...]].... ..6.
actor . Peeps 80-5 cust nn Feed oe ce ow vn Okeke wal Rain $ gers,§ lage $
: r / > (; ‘ ar = Mont. } Tickets, Potala» ais plane Service,$...]]....].006Size of Casket .2./.¢. 4 ak Lan. NE a alg ae Telegr., Phone, Cable or Radio Charges..... . .... ...Manufactured by: Ad ere lly aig, oe Com Advanced. ois ii ens oe ewes be ev calle onde oulewuc’
Cemetery} Out of town Undertaker’s Charges......[Jcnceeesfeeeees
Interment at.... 2.60.2 e sees e ecco eeeee ees oe a ee a ee ee ee er, (inne Owe
Lot No..... gue seeie'h MAIN, Putas cM soeseucidudechecuw
Grave No.... sesesees.. Total Footing of Bill........ece eee $12.4. )8%..
CMR eres set eles Bess vio 20) able Sides. es fee Le
Section No........ $
— pence
Balance....... $i. . Us io suede eraleie
Diagram of Lot or Vault CIMT Hic cite cows 4 8 RGes A Entered into Ledger, page... or below.
Date . Amount Paid Balance Date Amount Paid. Balence