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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

RECORD OF FUNERAL See
Total No......0. Yearly No.. 46.4... Date of Entry. ALAACL),.F... 19
Name of Deceased.. 2 7774/. &. S.C. eA SP og aS iA Ml, PA ee SIMS I ely Ve aE Me A
a Married W Single O Widowed C1 Divorced (What a
= pinch ah sonal Say he” Pee ecko ay ee ae eee Residence: KA wisS bed ibs oi Sette tee e cece eer e ee ees nee Se ak 5 } PER ae a ali eh me
sharge to: ar Lh. ie sco ttets. tintin 1
‘Ly age oy SY: Complete Funeral (except outlays)...... $ —
Address. PZ.. a Se cae ae Casket ek \oo
Irder given by. . // Pah, ba Keg A “oy Same. Burial Vault or Box . O1k¢ . Kye es DBS: . OO.
ori ani E (State
Jow Secured: :. fue CIP, nf a ee Le ee Embalming Body ec.. 2. isu cacsdeccsicesece Weabeccch cece
(Name of Embalmer)
f Veteran, Name of War. eh Cee a ed Se Barber, So. 22 sc hs Hair Dreasing, $....2.l). 0. ..ch.3.06
Dressing Body, $..... Underwear,$...]]....]...
Jecupation . Leet. veegee WAALS 2OGN?.. Suitor Dress.. sees ee
ine 8 Social Security Number) (State Kind and Color)
imployer and Address AY& Ye. .< CBO.. Slippers, $:.5..5... POG, BE Gnd en. coke
Folding Chairs, $.... darpaulin, $2. oe. th fac. bee et.
4 ?
Date of Death. . ,<// Veg bi. Ki hECO.. Ze A2LA.) Candelabram, WES. Candles,$......)..0 100.2,
date of Birth. 4/4 es bP ye Age3.& <2 .-+S$".. Door Spray,$..... WOW Sea. 8's SN 4 5 eee, wn
# Gio DayS Wr.) Cm) (Moe) Days) . Funeral Car, $.... Ambulance, $. 00. 22.. de. eee
ervices at. oe swathes co 6h oe Be Limousines to Cemetery... Fs ite Ie ed ob ck oon
; CEL 4 inh. Vexrd xt ee Extra Limousines ...... ee ieee ie . ee phd) eee
Nery as COA (Address) Autos to R. R. Station. ... 85s Sa Nica ey, ee
religion of the Deceased.. . 7s, Be dive tang + win oie Md Getting Remains from...........1....1...
irthplace .« vey LG ELE ia ek ae od sti PCMAG CO, i. haga os a vic wise pode cP Neco)
ZY Trip to Coroner’s Inquest ..........1..../eeceee
vesided in the State... cg Os ee Oe ee Delivering AROS ote cS whoa ie Mey lets Morente to oe
(or U.S. EE ity or ggg (Months) Deliver Pigeons to
] a joke SR Eee Ee ae eS AGS FES) alone WHR REe: 8S # & Ip 6 nee le 6s EES cial a ola: ot ene % & ‘ete
lace of Deaths ra) ae ate Maes, REL. ce Removal Charges. ih. cs cesvedssedec cece s¥ilhe. wh eb
‘ause of Death. £20207 ah. Cp ld Beg J?7.2a<¢.ce.... Procuring Burial Permit. .. Fe Repo eo Cig . al ak
Hern 74 vd ae
ontributory Causes. Mead Cyohtn . SEL AOOk ys. ier. Copigeot ge ae pe a
Pall Bearer Service, $.. Use of Chapel, $...
y RON kn eam Sblaleeld ie ee ooh Res na a thas son we eee ella Groh Tata BGs ae Es te i Si is
ertifying Physician. W2¢7?.¢ 7. Yel os 6 Upad se ole a ROMRY TOT ABN iter ss alc ds ora Vulew Morse al ee eee
= bier ; GES. joe LLE: Pe el OPTI ig oe ia such me's is. aly Se Ge he 5 fl oe ee
= Serer 2 Mlates a ie ee a pes Flowers, goes a? -Palms, $.::::Matting,$... . .. 2.0). che?.
iame of Fathernn / QZ €-§. et EC. OTF oo occ caw cnne. Rental of Tent, Sc c0f Rcbe Vault,$../1.. pon, Pen
is Birthplace. 09.6.6, 24602. Nooo ocvccccccccc ee.. Opening of Grave or Tomb.%. 27 45 ae tenes AS..
eee 2 Lining Grave, $... Lowering Device, $...]]....]...
Iaiden Name of Mother.. 62°42. 74. 4. OtHrehers. Outlay for Shipping Charges....... co eles a
‘er hirthplace:.... ro <a Mie pe Ratio jek ole Singers,$. . a -Organist,$7.7". ]. S. . O-2.
4 ctorf Lickets, $... rug Service,$ A ) ti f Fun La A t! LA Pe). ns wte ee 2. 0M. or Motor . . oe plane ee . eee i a 9
6 ai Mee Ab of Week) (our) Telegr., Phone, Cable or Radio Charges..../..../...
ns el Remains i eine de oleniele ets Seoleet Sars 9% R ghey SER ogi F CORR PAVERBON lt Mele) oe ce Wel ose
ize of Casket. A/ -. Wed Z. ee, va YUetY, Ane Sygate Out of town Funeral Director’s Charges....].... ...
te Color’axd Num! 44 Personal i sperm atalel din Sper C0 acai t'e gua mil lar ee eee,
fanufactured by. . Saas Ln. Coa EA i, 2..) grencke. Mit ker C663) 000 V ASI,
ometery cmetary re tb. teloe yy, .line ath Notices in... Papers ....1]..../.d.6.
ogee. i he TR cave bel ey Pita @ So kee Reena aera . ers a
INOwsec S Rah heabod ior URS DLR eT ok aki Ore eee, a pmo shee
SSK, "
CEE PUL en haat niaathite dine okies wale oe tans as cy cece G Ne th Sere
scat Z SL eB ee ee ie WE) oo salon western Me 12
a, eer eee me Total Footing of Bill........... $/2G APL.
ages pe Block No..... ty NOP ee Me, leas ay ud oa ees, Oe hd es $
Diagram of Lot or Vault Owner. .-.--.es.see en. Balance....... Bios Staves as
RUSE AMCOUEE TS 0 507.5 ond are-s vies 4.3 Op bank a os aets ihe ue. Entered into Ledger, page... or below.