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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

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RECORD OF FUNERAL
Pebal Noss soo.
vch ete
Yearly No... 4K..
Date of Entry. MAK GG. Loc cecccucceueee 194
Name of Deceased... Lh.acles. ae SHEL MESOs te ee ee ey hog Gane
Di Married = __L) Singl
0) Widowed
C Divorced
Charge to. A Ahi vuAiil. A
al IMs Steeda 6 4s ra
ss
;
oo
omplete
Address. i. SEL A wullee,, sue CAL: etal
sa ues evens nas
ea ye ae eae pat tanga
e L.A. oe
Residence. = LAM
eg age mle
(What Race)
a6) oiehetele
om
Funeral
(except
ra
;
outlays)......
E
.
Z
GLE
Order given by. .L<047.¢.21 &, Staal. -++++++-. Burial Vault or Box .. Lando? sen 000¢:. . . AO.
or informan
How Secunda
if Veteran, Name of War. it. Pie
a
9
Occupation
(State Kind)
ches
od hens oP aadas Embalming Body ... ( See
eee Cee
k
ame of Embalmer)
ie capo asta eerie as raacitel & “4 t Ft Hair Fe pales of psec allen ovo giefaie.s
ee ge
ressing Body, $..... nderwear,$...}....J.
42 HALF. eeAE: beesq SE CF LIPO ook Siew «dia ede yas wae es San ob oe ome
y2 Song eey Ronee)
(State Kind and Color)
Employer and Address . Se,he LLLtL. hes Whe Slippers, $....... FLCC yb Has spire ee a saan] a teed one liens
mL
DP Stho
“30 77H) . Folding Chairs, $.... Parpaulitiy. S$: osiess
« bilbcwee 8
Datel, Death. te a
ae6 “any
Aad Mh. Candelabrum, $.... Cameos Beni.
oles ancl
Date of Birth. Lz a ow, JPRS
Age SS. O =. S7.. Door Spray, $..... Glovesy'$. 2.5 6025 th as ale oe
ee (Mo.)
(Da
oo
Yrs.) (Mos.) (Days) . Funeral Car, $.... Ambulance, $. . .
2. 22lloca nec.
2 hal cere ee
Sick.
San
Qi
“2 Tae ee oe Sicrareel esiats.+++. Limousines to Cemetery...
Services at.
MIG 6 LCA
Clergyman. 47:
gp oOtl Lv \ Pxtra Limousines ...... fe ee ees
eed ace
A
apie
SX
Autos to R. R. Station. ... ge Be. ese
Religion of theDeceased. . os“n. vet eee ee eeeeeeeees Getting Remains from..
. 5c ode ee eas [ede fees
Birthplace . 4-4/2. LOG &. MERE, ee Taking Re IRA Na pr Mag oes)
:
hs
7
Trip to Coroner’s Inquest ..........]}....]-Resided in the State. Zp AGL.v.eeeeeveeeee reruns Dieeintig sve
ee). Siders ice odhay Salfcliareee aaaes
(or U.S. or nig County)
(Years)
Place of Death. SALLIE. ME. 6207..
5
Months)
Deliver Blowers re
Cae
ae
ef Eh ee rad eer em
ae PREM tae 8 eee er eee
Removal Charges........eeeeeeeeeeeeleee
eee
Cause of Death.
(44 2/2A, MEMMIDM GEA. _. Procuring Burial Permit.........00.[fh.000.
Contributory Causes
A
2
pec TEAS/s a. rtdae
x2 Certif.Copiesof Death CertificatesNo.
eiikal
‘
(State Physician's or Coroners)
\.2
iL .
UIE LOL
Sess
ie bit
ee
ee
Bf,
gee,
te
ros, Total
for Sales Tax. 300 650% cee one Bl. o> on cles
Certifying Physician. Wd 5 aE
< 2 Meme. --. Outlay :for Lot. 6776 xiee.dGa
aa ‘Bax
or
Coroner:
chy $s $jeq
His Address. LLBES. LEME
¢
See See
iene te ey
Te
Cremation Sls . e #60 \oiteusl @ Ss) sles) 6 ashe al ulele eae
abet Caras Wink
= Seo:
4I
Flowers, $... Palms, $... Matting, $ 2 .44.i
vi ven fe 3
Name of Father. La $. SP? Lip Mes setetere ahs Rental of Tent, $..of Tempo
Vault,$..H....[-Hin Wipiiaplanes bad 07 Ak
Maiden Name of Mother.
cy sate ea Opening of Grave or Tombet F4.25.4%. Z... aes
:
Y.
Chee Aah
;
Lining Grave, $... Lowering Device,’$ .../. ....
“AG SA.7..) Outlay for Shipping Chargessip it trite sa Hohe
oo iba ok
Her Birthplace. .. igh ee Ni Nes, eee Clergyman, $2 “7Singers,$v.~. Organist,$>.-.. . . 23/4
Date of Funeral.
ee
Mh
Oe
Atlee
Moat } Tickets, $.... plane
iano Service,$...][...:1
D446. 4M £60... xe Leh m. 0F Motor
(Date)
(Dty of Week)
(Hour)
ater} Remains to pipes cebie
yr aiaesees ps
sie of Casket. 2A MLE Si
~~
(Otte Colorasd Numbe)
Manutentived hy cae ee et OS “2
Pe eer
URS
Telegr., Phone, Cable or Radio Charges..... . .... et ER Cash Advanced }. 0. sa24.00. ccs cen cds las eecllocssccadles
fleeces Out of town Funeral Director's Changes..00.). 00000).
i CA..
a
Personal SOrvice.g.)s6
ale s Sie we ais seule cats ave el
eee cles
=
ee
. Ce
ee ete alee
en PAs eh, Ea
Sf? No.. x een
Grave
Be
ee ee ern
eee
pe
Sales Tae an as ord hc leet. cates cute
LS~
x
Coe
Rickettsaris
eo cit Total Footing of Bill......0.e0e0e
eee. \. .2/2.3.
—
Sor
Diserw al Later Vault
Miscellaneousrah SH OR Se © Clinelele
Block No Piatti
PA A
OS
Si
Less ee ee
OMEN cpeciisiee boeken tte
8 pis) 8 Ae Ria @ Wi Suara: owiehe Wlele Ene ead le
ee
rd $
Heladee
ee
ee gi. ...-[.
Entered into Ledger, page... or below.
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