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Collection: Original Records > Death Records
Mortuary Records 1943-05 to 1945-08 - Index Included (343 pages)
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Page: of 343
RECORD OF FUNERAL
Date of Entry.. leaaceued L.
«es
Name
of Deceased..7“4ce-u.
.
C1 Married
1,
D Single
eocavang ge geet Saad tas sail vee er toeea ye My gt ree apne ae
[CD Widowed
DD Div
ae C
KACAAR LEY. 2c
. Address. .:
Order given by. Co:
Lr <
.
How Secured.. .@e-7FZFATR
Tf Veteran, State War..
Occupation .
Date of Death. 4
ad I
(orinformant)
a a Briel VaGte OF 00K oss
Services at
ergym
an
Embal
ccc cc ces cnceccuscess
=
mbalming
iiss so sie sons own ee ed odie eu ele cx
(State Kind)
Body ... was pee
Suit
$ Oe
uit or ie
nh
AAMLEE,. L.BbxcALM. . Folding Chairs, $.... Tarpaulin, $.....])....)..
pi=O.in
a
A aki a. ‘ase
(Hour) . Candelabrum, $.... Candles, $......].c.../..
-. Door Spray, $..... Gloves, $..... CoM
netece takers
ee Funeral Car, $....Ambulance, $.....]]....[..
Limousines to Cemetery... Leaean
ncs
hes BeregOF: m. Extra Limousines ...... DG
dre ait ulle care ake
pe
Yay
(io
Autos to R. R. Station. ... (OOS sac ciicle Sethe wiser
ct M Al kaatcea. . (ha Agee.. Getting Remains from............ )..../0-Leann, Ayako fa, . Taking Remains to..........00
feces eee00dee.
fede:
ddr
‘Trip
to Coroner’s Inquest ..........l]....[..
Religion of the Deceased.
Birthplace . 4
‘
LOTE@.
ad
ced De
Zusa
oo ev eee e cence Delivering Bow toc)
ne ee
~ Resided in
i the State BERSBS
«i
i~A
= Place of Death Zee
ow of Death. Charged
Ccateibatr Causes~
;
Bod
Dressing Body,$..... Underwear,$.... )....]..
.
8 ace re eh Pensa
cabs a
6.0.. 5 .cd is eee t chew vepenns Slippers, $....... eae Soo
eee
(Date)
Oo ae
Complete Funeral (except outlays)...... $. F312
doce ccececuceecseesdeecs Barber, '$.. 0006.8. Hair Dressing, $....}}....}..
Date of sia
: Date of Funeralom.
(Date)
Peer
Age of Husband or Wife (it Bvingyiisssscssessercces Ye
ccc ences Ci
bet AAW(Social Security’
APIO
&
Neabes)
sbmployer and Addvess:.
vets
ak
OE caged cesesienes vee of
cece
occ
CLOBAG
L710]. f
harge to:.
Wee ee..
(What Race)
Residence. ZI
UAeasank
.Re TS ae
Ze
f
Werathenr.
——
e 19
eos nok sccdln hoe cia'e Moree
Deliver Flowers to......ccccceseccccecll....
Removal Charges........ccccceeeeeeelec
cece fees
Procuring Burial Permit. foiabs
. Since ad’bidaea’
Oe ciae : ——Certif.Copiesof ee
ysician’s or
TPE
ad
ers)
. Pall Bearer Service, $.. Use of Chapel, $. ... }. Y00. oGross Total for Sales Tax.......... $i}.. 8. AZ.
Dating Tor Lt 2. Ai. nec detecs lecdcas teste ie: cae
CTGRAMEOM sso rae Pie kok she own cei wtl coy ak . £0. .0x
Flowers, $... Palms, $.::.Matting,$... . ....]..
Rental of Tent, $..of Temporary Vault,$... . ....}..
Opening of Grave or Tomb.........]]....
Lining Grave, $... Lowering Device, $... .... .
Outlay for Shipping Charges.........]. ....].
Clergyman,$... Singers,$..Organist,$...l]....
Rao,
} Tickets, $.... Acro” Service$...11....).-.
‘. Telegr., Phone, Cable or Radio Charges..... . ....]..
Coen AGVORCEG 5 wel on neo eee bok che ube lus
Out of town Undertaker’s Charges......].... ..
aor EU
Die e tes eat bors
ee
fos
natedee
eee
eee
wee Yi
ieee
Mieodeeee
Pilea
Cutt:
re
tee
at
lie
Shbe.
eg Savas Ba
Total Footing of Bill.......00.
000. $.. X22
. Less...+.44. Mit Sarvislanists sinigalel el deetiosets Sek
.
ee
Balance....... ee
Entered into Ledger, page... or below.