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Collection: Original Records > Death Records
Mortuary Records 1959-04 to 1960-10 - Book 30 (326 pages)
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Page: of 326
me OnD OF FUNERAL
Total NOss <i cis vc ccacinss ~ ae TAR Spee! Date of Entry. De ae Z elec elsraiave ne aielete ie 19;
Name of Dicased. Ato. on ak Tue EL Oe nt RR Dae Pee Siw:
CO Married. . 7 Single ra Widowed oO Divorced (What! Race)
Residence: . eg eZ, EAE: a. ue Dalai feagit Bs ae ee AO
= ; ‘od y Le hh oath) oh ua ass of } Age of Husband or Wife (if living).. Y
TOs L650. SF hE ie ne
Charge to; LE wae Zz’ Complete Funeral (except outlays)...... $
Address. «2//. Ch PCa Pega evs cell nt en eee y; St z
Order given by. de: CMG. r PDEE) Jaca Burial Vault or Box hd. -Chted... IN. =
\ orinforman
tte: in ch
How Secured :< PRs sen elaes the BeLcs 9 Oe. soa chan Se eel Embalming Body as <8 (Name of Enibal on adem nan aE 3H ic SORES 3
If Veteran, Name of War...72<<?.......... es ber, “ aoe ne hacen s Hair Dressing, $..... ....
hatte as 1 By gt ressing Body, $..... Lyre My tM le .
Occupation. . KYA ne a ae AE a Ore £22 hes. Suit or Dress . Wate 12. a aa aa ae ites QELS
Employer and Address . 67? eee Slippers, $. Bae UE We TORT oes cae ee ee
L SK “15 fr. . Folding Chairs, $.... Tarpaulin, $.....)..../..
Date of Death. cz, nee Ae Ai a “*-! Candelabrum, $.... Cuidles, $050.. ale. eta
Date of Birt ee SLA EDL. Age .£¢2.</2:./57. Door Spray, $..... (2 Ce See nk” oath ide
cM) Day) “Ws irs.) “(Mos.) ‘Cay Funeral Car, $.... Ambulance, $...../. ....]..
Services at.. 4%: Pet Abe iT. Kkfecercre . + :. Limousines to Cemetery.. . Cy Sa a ae ein, ae
KG. biwnag ox fe —J£,.A/. Extra Limousines ...... SUS See os iy tac, Be
Aen ~. . igh bee e Yow SOAS.
Clergyman . ddress) Autos to R. R. Station, ... 2 SSCL mete . SAS eed
Religion of the Deceased. . . 7 ns nea Getting Remains from...........1.... ..
lé hiteteay . ged ak A a ee gs Taking Remains ton.. 0.00. oc.cecsecruedtecc.. ys.
aes ha FF < Trip to Coroner’s Inquest ..........1].... ..
Resided in the State” re wo = ES aire recs rege sn Box 4 Rat Racal Stes pee Pele te dake SiSeELS SRA aie ineecher
Place of Best ead Ate, le (Acc loy, Kh gaz CHVer HIOWEFS TO.. 1. eee eee ccecssdncvcull,. cu .
srl Removal Charges.. 0. sic.. cc secesece cecal.. ho.
Cause of Death. », 2Ay. OC Ae Z, tal Sick A . Procuring Burial Permit... ‘okt ory eee . Melee Ga
Conttbatory Counen' Cre tee Lé ‘ans . Certif.Copiesof peg Ese Pe ey
Ot. TS es od cian’s or roner’s)
Pall Bearer Service, $. . . Use of Chapel,$...
ie ous've.bielaecita+ eninticelMe ain’s-»' J cle, Cw-sikg Pig sce gs ee thd Content. Meteo Soe 2
Certifying “—, va Ala hed. Sap (deck. SMa NOR OE ones cited deine a ey SL / ae ee ae
i iv ire ile CPORNANAT 5 ins vie hn Caw sh ty ey dees
His Ad ee Ree lj ae Flowers, $... Palms, $:::::Matting,$...]... . ..
Name of Father. 72: Liaw, Lal AK heel, oo.. Rental of Tent, $.. .of Temporary Maal, $... ft.o. Jc8t.
His Birthplace x Opening of Grave or Tomb.....:....]... . ..
Ce baie ie ee a Lining Grave, $... .Lowering Device, § eee, ee A aie Mae
Maiden Name of Mother. .:AA-¢x<v. ere ne Outlay for Shippjng Charges. . EE oiihn we if 0 ge ty ae
Her birthplace: . iw LE. P iscal iugra: SapaistNag Wiel O pee te Clergyman, $/?. ies on aah = ~Organist, $2" So + fE. S58
Dale ot Funeral Wkae Alas LZ AIG.. ice ho Ge Meter} Tickets, $.5°£5%, A Service g. aos eo
ae pee of hi ra Telegr., Phone, Cable or Radio Charges..../1... Ak
e"} Remains to. bed . 4 AL A ect 4s ES AON ORO A un vive bony es il eee.
ferrr
Se
ad of Caskets? 7. WL oe. ee heme: _. Out of town Funeral Director’s Charges... . . 97017 7/777”
4 rand Nuz POOREST. PS Senet hives ses oscil cen, hol,
Aihscrlanthied bp eat An a Be Se el wie ol allege teat st ea
Coinsteey L, line Death Notices in... Papers Me as
2 SE SD SERED HACE MR hy ae NR ole a eae Pe NR CUES. Sea
ws Ne (Names of Newspapers)
Grave No Oe 9 OC's 6 Maid ew ee 6 6 of nn 8 eS SOLe U8 we © tis 16 6 06s 066.6 0.6 0 oe Es C8) 6) 66 6 © lle + 6 oie © eh es By
glare. SCAM She cheer aca VU a a Bs ence Z17£
Pec res Ber AU eee gk cine negra ne Artis Total Footing of Bill........... . Eee Bs
—— r— Block No..... 2 oe © dhe $
Sn eva ORB ho ink ee + HRD ey Balance....... $ Vs GINO}
as reg as OE a i ea Entered into Ledger, page... or higiow: