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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
‘Total Mice. eae eek Date of mp PT . ey 19
Name of oe : AAA “KET se ee vp ean stil (Giicte bic scmstgi aes a
Residence. ..
i oR fae Be dS at ee of Viidiend« or Wife (if iin
Charge to. a
Complete Funeral (except outlays)...... $. . 29 21.2
Address. (\AG70Z0L10 ee. LETS. oo cee eee Besa BYB\e
oe mg ee ate oe eid Pale Me os ca oe ue
(or informant) (State Kind)
How Secured. een LEN oin wie eee Lalloode § adabs BEmbalininevsGay <2 5% nase cts Wack allle ceneahts ae
(Name of Embalmer)
If Veteran, State Wear isso os ign esa ke ee Ses Barber Fis csisisicny ans Hair isan PitenisiscaBeltes «ds =a
Dressing Body, $..... nderwear,$...]}.... i
mae 32a Ll bale abe. P . y.§ $
oy EG OREUROSSe eae Oe Seo nde fag ee IID ae ee a
(Social Security Number) (State Kind and Color)
Employer and Address «77.. 06. +. secrete eee eee Slippers, $....... Haase, Se woot. ec ee es ul
Date of Death. ZAKS.. AEG Folding Chairs, $.... Tarpaulin, $..... ).... ml
he Ze. (Date) (Hour) . Candelabrum, $.... i Se ees, nea a
Date of Birth ee AGALAE. pec ids ae Door Spray, $..... GloveasS co ae “i
Funeral Car, $.... Ambulance, $..... ).... os
Limousines to Cemetery A eae De Seas c Shes Fe my
. Extra Limousines ...... i ene arc oleae = Coe es
Autos to R. R. Station. ... OTR OSE aay ae ieiey . recta qe
-. Getting Remains from..........-. )...sig
RR, PBIIANO Saigo 6's 5 Anes Siblanae Gini « 20 ese me
Deliver Flowers tO. ....0ccccceeceececeeclec cee We
oo Removal Charges oo. 5 sence coc d so cacescs se cclli case: 1s
Resided in the State/? Aya. .3. 94a P74 fe
(or %3. or fede Sat a3 Procuring Burial Permit. o-oo si guano
Place of DeainLegrea a. A sO csi ___Certif. Copiesof Death Corttimtenne ieee ea. A
(State Physician’s or Coroner's })
Cause of Death 2 Pall Bearer Service, $.. Use of Chapel,$... ].. aye f
Birthplace . ee er eo eT
ee {of fMddress Trip to Coroner’s Inquest ........--.//.. att Ae
Religion of le dated ails Delivering Box to
eee Gross Total for Sales Tax Sin iatace anne excl phoetere $. ...%. z
pay ee ee Led erate 4OF Beats oon nes ce lhe a bis
LE. Vaeacwed. ; PRL CRCTAREONE oo ocho os pike neh veere nw see has ses nhs
Flowers, $... Palms, $.::.Matting,$.../}.... es
Certifying ee Bee . teas ++! Rental of Tent, $..of Temporary Vault,$... . .... .
Fad AGdweas.Sa i "FE Seebwoaae GeO Opening of Grave or Tomb.........]...; i
3 ; a Zz wy ‘ Lining Grave, $... Lowering Device, $... . .... Rig
5 Name of Father.... Feeeee Sek WLALE 12s Veeee Outlay for Pieces CEAIOG eo ee ces ss ec Pul. Spe
© His Birthplace.. ge eg er en * Clee rma? <7 7Singers,$. . i -Organist,$...]. .. 2.\2
ee ms iroad \ Tickets, : arene se ero Service,$... }.... ca
» Maiden Name f AD OCUIA. occ hee
3 Telegr., Phone, Cable or Radio Charges..../. .... ne
+. Her Birthplace. .. MIDOPELERECA] neces Os ae ee a ae eept "} Remains to Zz,-Out of town Undertaker’s Charges......]]....).
Leos LAG Griodel pan PEMD sin nina pone tin tls doy sin ysl pes As ch ty
Ce
Lidt No ee Oe i ai iri irard . aca
: Sales Tax’ cd asd Sunn eaeiuah Meal Neen nosy arg Kage ined —
Seat sar ea loci Total Footing of Bill........... SLPIQ4Z
Se aie an ae) TM phen oes wen sacra nin na 3 Sales PCR Oa
; ea eee Gilestes reek BH. SSA
Diagram of Lot or Vault ttttseseeeeesesseee!l Entered into Ledger, page... or below.