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Collection: Original Records > Death Records

Mortuary Records 1959-04 to 1960-10 - Book 30 (326 pages)

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ad Single efResidence: . Bos py fo Sharge to \ddress. . at Irder given by. Tow Secured. . eae f Veteran, Name of [email protected] eens: SS2-05~ PhS) Jecupation . Ril tea: Aiea. PER eee ae TR Rit Imployer and Address . ey Pe, el ie, ee Yate of Death. 7% 4...°74.. CA8%..46: #E LA. og Whe. hee FR.. AR eel elon (le. Age 5 3..57.. ah eee Meg, Phe (Wr.) . (Yrs.) Mos.) (Days) services at. . #.777¢! ©, GAARA ven en ee cees Yergyman /L¢s-. Ahh. Pik: BE ee a le AD) (Address) teligion of the lol ROVE EAN seen . S ss tial se'y Matis Re OTST: 3irthplace te eae saasan tesided in the State. . Ad % ; ig ei hy oe asain” lace of Death. Wevod= Peaster’ AGMT, MES. ay tel.. Jause of Death. . Lard eens fae, eee Jontributory Causes. 644. 92.'.<. 2? Yor otter.. Jertifying Physician. LMithtesd ll Pr we, tedk, Bele share or Coroner) lis Address. : 4.44787.. iF, ye “i re rer Jame of Father. Seared: RE “he Volto rhes lis Birthplace. ..C.Paveereeae ec ccceeceseeeeees Maiden Name of Mother. ae aah wr é reach. me ter -Birthplace . ..,)Sw4@sFecaterth. oss celine 6c eleie ede wens Bee Le es ZIG.. 22, ‘3 eA] (Date) (Day is Week) (Hour) ea Remains to..... lize of Casket. . 222. AA 4s cy ae Lot No.. 044 Freee eens. Grave’ Nou.. ccc «15 oGie0% Section No.......-senlias Block No....sobiv smi Diagram of Lot or Vault OWS b .rigs shee deed Helis MEU OOOEE «i. fowals xn llanwaiel sc obec nanos Uehara ees ee rr as i . (Name of Embalmer) Barber, $...... Hair Dressing, $..... . ...-. ..000 Dressing Body, $..... Underwear, $.3 2. [. 0 .tecd lee ecb POE OP LITO foie 6 Ses we Gib gles vcard viele ous’ olay ve lhecce le ha eles whan (State Kind and Color) Slippers, $....... TORO eral eee sls chat lpletb alll lccriMbeacliets eee Folding Chairs, $.... PPAPDAUIINAS sl vt grsyall shear wielstads ely.e Candelabrum, $.... Candles, $.....-(. . 0.. feeeees Door Spray, $..... CG [oe re Ging et . PA Ie Funeral Car, $.... Ambulance, $..... [....)..005 Limousines to Cemetery... TED is a ctocarceas asd be Gece bow eRe Extra Limousines ...... Os Sar SI or ate . ete dip (Ce . Autos to R. R. Station. ... Ce bcs re imei ede bash Getting Remains from........cccceellec cece cleceers SAIN TEMAS BH ye. 5 ab os 0s await ony ole noes doawhes Trip to Coroner’s Inquest ........e0eleccescclecees . Deer ti RIOR DS divin d sre aera skal Fe Gn vie Kle'd vate Liceul Hela OBS EMORVER TOUGWONR Tia ics scar sso 60 ook ick dvle's onsall cou artedulewne . Removal Charges. fis lee lee in ohsallen caw uldoe waa Procuring Burial Permit ..6 5.66 is 6s dose cu colle oeecculedecee State Number and District) __-Certif. Copiesof Death GertidonteeNo. fo Rls OR: £).42. (State Physician’s or Coroner's) . Pall Bearer Service, $.. Use of Chapel,$... Gross Total for Sales Tax Epa Aotaal a te a . ORCA PI TOE EOE ¢ exten ge sg by oe else econ Coes MMII ON, Sates I romans Falk aun Seas cle Abas calle Paves Flowers, $... Palma, $.;: >: Mattingy$ 0.5.0.0 .5 loc dves Rental of Tent, $..of Temporary Vault,$... . .... ..-Opening of Grave or Tomb........./].. BS . .e28., Lining Grave, $... Lowering Device, $... . .... ..06 Outlay for Shipping COTES cmt. Sot, ce Ny 4S ele aite Clergyman,$ /.Singers,$..Organist,$32-, . 1:3.) 2 0.0 Railroed \ Tickets, $.... dro Service,$...]]....].s00e Telegr., Phone, Cable or Radio Charges..... . ....[.0e008 CAB OVEREO Mia cate oem glnn cob c cclaire edly choc abs Sees = . Out of town Funeral Director’s Charges..../. ,...J.ceeee , Pg gs MOR ite ear aa ae ee MBCA RD! ene » atrrin cert heed, ooccccccececcues B9,. .0R. .line Beath Notices in... PAPO 0 ive ices canted ona ewe euies Laken ake Gibeaod Ridetetcg Tete coffe nee ede tee Bale eae ira ec jn he ass oi ale na cet ay £2 £ J Total Footing of Bill.........e eee $. . 22 Z. Az. TEOBST. ss srshs graneivlatehls. «'s vvis alata a aauel Garem ehe $ TSRIRSIOD.« 6 55:25 Si Seetsele:a Sila 25 sl bieleietsre Entered into Ledger, page... or below. Miscellaneous i ee ee er ar ee a)