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Collection: Original Records > Death Records

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

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186 Total No RECORD OF FUNERAL — Date of Entry Name of Deceased.. A: VHOCCE at Liod CeO Te. Cpt he ALKA (0 Married CO Single [Al Widowed Residence i22.0.82. Hubhuka. 8? [ Divorced . Charge to lito bd itt Z He 2) nee een Address. 4° MMi s La ache Le: og a ge Order given by fh Abo wt SAMBA ODT, LE How Secured. fC 0tEX If Veteran, Name of War. WA a4 TE, a ciate ho eked ws vie OR Occupation Suede: Chek. SEG SOME. (Social Security Number) Employer and Address Cras shit dey OEE) eit. Date of Death 4/ 74 rt GLO. ¢ i (Day) A (Yr.) (Hour) Date of Birth. £7; SLE Of. Age Sv. RP.. 0. ay, (vr) (rs) (Mos) (Days) Services at Ze grvii x. Mth ORT: Clergyman. nh Nanrite. Resided in the State.. (or U, S. or City or County) (Years) (Months) Place of Death. “404. Mi. Md tt. MheOosf?. Cause of Death L/i. C00 LBL lis Wins ches noe See 4 — . AContributory Causes. We 7@S-TH We: Let ME OL? See Certifying Physician oes His Address.. L2aSS.¢ Ale es. Name of Father. <* étak. et & MOLES ak 7 tee . I His Birthplace. . Pe £ay C7; a tg cit oe Nostra ee Maiden Name of Mother“. led > Le baw. ah Her Birthplace.. ha Lab alee stole Bias ae oP aRe ea: aes Date of Funeral. WA4. = LEG eR C0. HM: M ( ate) (Day of Week) sip ry Remains to . Z0t_6 VA Lo) fp Size of Casket. &7.%. Ane. IAT GF is lous JF) ay: te Color ¢ e SHO égé, (Si Manufactured brite at 4 SI) St IRE AOE. «ockk oe Shadnves = Diagram of Lot or Vault Miscellaneous (Name of Embalmer) Hair Dressing, $ Underwear, $ (State Kind and Color) Hose, $ arpaulnye < sees cac Candles, $ Folding Chairs, $ Candelabrum, $ Door Spray, $ Gloves, $ Funeral Car, $ Ambulance, $ Limousines to Cemetery Extra Limousines Autos to R. R. Station Getting Remains from Taking Remains to Trip to Coroner’s Inquest Delivering Box to Deliver Flowers to Removal Charges Procuring Burial Permit State Number and District) _ ¢ _/ Certif.Copiesof Death CertificatesNo. State Physician’s or Coroner's) Pall Bearer Service, $.. Use of Chapel, $ Gross Total for Sales Tax Outlay for Lot.... Cremation . S04. + Flowers, $ . .Matting, $ Rental of Tent, $..of Temporary Vault,$.. Opening of Grave or Tomb Lining Grave, $ Lowering Device, $ Outlay for Shipping Charges. .,,......55 Clergyman, 5 /0.-Bingers,$.°©-Organist, $y ~ Railroad . Tickets, $ Flaws Service,$ Telegr., Phone, Cable or Radio Charges Cash Advanced.: : Entered into Ledger, page Miscellaneous