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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
00228
RECORD OF FUNERAL
Total No.. . + deste sss Yearly No.. /ZS...-. Date of Entry. ke Le on aed eee 19K
Naical Deeeaned CCE e ae, ev ale ooo. ccic nods nce Wi dee pcn. Sp
KI Married oO Single (0 Widowed 0 Divorced (What Race)
Residence. O44 AOL: « PRAGA oie de as pr ect: ee ey oe 30
Sener 0. ie} usDand or ue VIIIG Pcp cccuewecvecouse ea;
Charge wo Ls. WEE te LEZ A lel. ov vcccees i tos ay
mplete Fune A, a) ste ous Teas
eo ty Hh heres Kalle by --. Cea ee oie
Order given byVis. SESE hn Ae haa CO BSBik ivi. Burial Vault or Box . kiereet. M2 be arate ss % CO,
or informan (State Kind)
How Secured. / (Pea A oe A TO i ode pala fh ae Embalming Body Sit ie /eme Gis of Baabaianet) ee . CeCe ee
If Veteran, Name of War.. 7.¢2...cccceccccucecee: BAFOel, ia fo. eyed Hair Dressing; $. 0.. ols 460s [aers s
Dressing Body, $..... Underwear,$...}....].
Occupation . Mi) Me Mides. Pda ee OF VEE Be BG OF MONG ic gd aera Sls grt la ens eels Hata-ok
Social ap eee (State Kind and Color)
Employer and Address Lx. ais. b. @ bes ay Mj itr e-~. Slippers, $....... Homer ge sue Fig tales sob elee
Bho Folding Chairs, $.... Tarpaulins tS «keen we We asco ele
Date of Death. .//2 oye eS ee Cals een Candelabrum, $.... Candles, $.:+. 00.0.0 Messe eho.
Date of Birth. tee AS SFOS. Age 3. 4 £,-3 @ . Door Spray,$..... Gloves, $. ky tks Ee eee
Soy” (DS) "sd (¥rs.) (Mos) (Days) . Funeral Car, $.... Ambulance, $.....l]....]..%
Services at_ 6 OMA kA eae eee Limousines to Cemetery... CUE Sea GALE agente . e ALi: (eM
Te 2s sok nae ey We aaa Extra Limousines ...... COSC case acts) ated [asec ec
viol hod a Meet Laks 2a (Address) Autos to R. R. Station. ... MA Aidt S. oa we aan > aa A EL en
Religion of the Deceased. 7.7.62 /...-. sees eee ee ee eees Getting Remains from.........--.-ecseaeelees
Birthplace .Z. ‘e ti f= 7 ni a, er TM my tT Taking Remains to. . 06. es ba eee calbed se eefes ey
Trip to'‘Coroner’s Inquest . .. <..h6 6 og se ys ew
Resided i in the State A SYS Fakcohb ie ew wie ES mae © She etme 0-8 Delivering Box 522 See aco ee . . He Oe NA ga
eo. 7 se er ie um, Deliver Flowers t0....;scceccseeeeeeeceall.
Place of Death 4 Le. £: ty. / an es ee Removal Chinieedase 2 hg.tean sf AO 100
Cia GF Dict nic Ao cathe t as oti le atte eater Procuriig Burial Permits.. 02.0. /esga 0 cee esl. dae ahs
a * Certif.Copiesof Death CortinentesNy rats a re
Contributory CAUses. o's sr, chclee sete le clots stavecres @ eles @ reas P (State Physician's or Cnees Se a ee
Pall Bearer Service, $.. Use of Chapel,$...
fies! Ri NTR Simla ahMilevertis PRUNE . PEM SCAT te cull 48a! ane 6 SPEEA: « Catan otal tee Sales itis 5, tea ae = ae! we
Certifying Physician...... ieiGaciaagh UCR TET e ones Outlay for Lot AE 6-23 Sk eae ASD ae
CTremations-2 cess enters aoe ciel clels a sites es HOU ace, Hels
FIG AGOr OSS. 5 cco ce si sratitvore babii = Uieid Rrdve Crecgeo wetter aid axe) ser Powers 5." 2 ae ae Molto €2° ul anette
Name of Father Aleve ac. oy ey =f hile CHE.. Rental of Tent, $..of Temporary Vault, ae Be ats
His Birthplace. . ee ett es a ee Opening of Grave or Tomb % < Clesgap. BS. On
> Lining Grave, $... Lowering Device’4 SLES ee Pee Stara
Maiden Name of Mother. 47.7.4 Clo Zl. J Laas Tey Outlay for Shippi ing ES teat Rieger Kot cecneh Beat
Her Birthplace.... eS Ff. La a. Ya siuclaiaw sive exhale Ciera, ). <.Singers,$ «Organist, $5. ASE
Date of Funeral.. .//# Oe pore bn Lo.. Fee. P.m\ Motor} Tickets, plas oie plane Service,§... ....J-++= (Date) Bay ot Week) (Hour) Telegr., Phone, Cable or Radio Charges..... )....[-++>
she ry POCTARIIG TO 6 oan died Bitere daly ie d ak SK Bee ole ayes CBB BEV ADOC, ose cerchy ve Uicaeinta tic p34 Sa caeee oetted s bm wefe ee
Size of Casket. “2 2. Ke; fe CIE OE Out of town Funeral Director’s Charges.... .... State Color and (Ge Parhonal Servite. 5). ssc ae. o's gies sc oe aol y bus xe Soe
Manufactured by. = ale. LABS Melo Cy. cece LMHS . AOINEE. BE . 4A lez
Cemetery i P pa va . line Death Notices in... Paperes. ssc alters > «
ERIM ee HE, 2 Gina tiicetcnay Otten eefees
rn ena ne or el EA OnE ie a sided anes a
(® ase ae dna Streak oe cile acalh SoS S, Cathet oneiie: axes Miss enero! we eae, vlale OL9 101 (a7 6ild) US ene IA en 'ales Dc wo8/ 9 as eee
Leen, oe Giles Pht ce canes cece hie tebe debe Meee £5 . ZA
Oya) clea Total Footing of Bill......-..0e+e0 3 Z2/7.\ 43
— cc Block No eee eeseee Pecesees Le Ss
" rf £
Diagram of Lot or Vault Owner. ...-.6esee esse. Balance....... Dis = ste sie
Miscellaneous Srelegrh <\eglece/ml © ses she yeleialeie ie . 9 6696's lee sts ele enn wap Entered into Ledger page... or below