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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
Total No...2.esee0e. Yearly No.. 492.... Date of Entry. fetal. 22: ORE, o novd ve ties 199<P,
—— Ow
Name of Deceased.. L2H.. LAL c ccc neces ec tssecccteensencasess Ml Cee. piel ie
(0 Married PR single (1 Middowed 1 Divorced (What Race)
: ea
ay ae A op Ges odio verre Caw ele ee ee ip t SS ee eee so
Charge t fete 5 oe eee Meleree oe eee eur i desars) A
; omplete Funeral (except outlays)......
Address SEE EL” Late LD Ah Made) CO ——— ,
Casket Hep eentetied .., 5 ie gy g++ gent rare..
Order given by eet. 40, 7 {ee TR leas age Burial Vault or Bo iy. ear Jl. . FAIAQ,.
or informan Le Kihd
. E i sjede"s 5 Sy © Oe 6 66 a O ehe 6 6 oie & sie ail] oo 6 08 © Sills 6 6 w ele How Gennred ee BEI. oid in spe Pal a aw Pa PEs Lee pele mbalming Body Pa
If Veteran, Name of War Z.... cece ceccccecccuees Barber, $. «0.00.3. Hair Dressing, $..... . ....)...
, DD é Li 482 $3550 Dressing Body,$..... Underwear,$...)/..../...
Occupation LGKnsMteew7. 6. ..---ee es ty . enor Diese. ok. Ee
Employer and Addredtic 0.. diasws dees ose ches Mea tw ee Slippers, $....... MLOSE MIE va s'est cs inscll's c1e 6 dla ee
Bs ssh Folding Chairs, $.... Tarpaullny Ds.. 5 » all.. eels e
Date of Deat (Mo) A ite “a. AR CU ‘. Candelabrum, $.... Canes, Boe. c at awte ck Sobelens.
Date of Birth At AbEL.. Age ZK.£2. 2497. Door Spray, $..... Gloves, $.....0.0.]/e-cccesfecess
o.) ee. (r.) (ira) (fon) (Days) . Funeral Car, $.... Ambulance;'S i.. 608s clas « stelews os
Services sp Lilenote vette tee eee eeees Limousines to Cemetery... BR oes oso avila eed a Pebe wale a
ds ; 1s 2 LO eee Extra Limousines ...... CBee). can oie mre LA cole «eval wal»
ule (Address) Autos to R. R. Station. ... CDSs se cece ose alles rete cele weal
Religion of the Deceased . Pe PEE ois 6 d's vb a pms eee lbl bs Getting Remains from........0e.eeecllececeuclecees
Birthplace Soerenc@X : Layo. bee ew ot el Talcine Peniarss £0) os ek wie s eka we neees fase ees beans
Trip to Coroner’s Inquest ........-0{lec ccc efee ees
Resided in the State 73. . A447 200.. Deliverne Borte os iT a2 eee. oe Se
(or U. $ or City or County) (Years) (Months) D li . Fl orale
Place of Death fo, LO ee al eliver Flowers to..... wade eerecceteneelice se veuhe eres
Removal Charges.....c.ccccececcee sees ccesccfeeees
Cause of D éfaanl, Corciusnctiea,, —} ae Procuring Burial Permit. .. od Washes “ed piston’ cpt
‘uml an ict)
Contributery iis Gh. ; R ; ye By ack ——Certif. Copiesof rq eS fos Aue oeoe
1, tne Pall Bearer Service, $.. Use of Chapel,$...
ee cde at st ames ds an Erk . Gross Total for Sales Tax..........$H.... [e000
Certifying Physician/daCee GL. A MMe.. Outlay for Lots.. ike sie ga le enevtoes-acsfliveeieufe coos
. Scie CRREIN CIMT ose sister ct. pas as Cialh o dite vc La docelhen oo Rete
pra . Li Cate. ie CD} Flowers, $... Palms, $:::::Matting, $...l. ..../..Name of Father. : . ABE Gal, Rental of Tent, $..of Temporary Vault,$..]. ....]...
His Birthplace, Ye peeceh6?. .<oo oe bocce ccndcn ee. Opening of Grave or Tomb.........1...0.c[eeeee
i umeplee . 7 Lining Grave, $... Lowering Device, $...]].... ...
Maiden Namb‘of hth. KF. A naber. Outlay for Shipping Charges. ........ Bae
; Cle an, Si . Organist,$... . . <2.) A.
Her birthplace pag oo eee ee eec cee eneeeee eens Baise — eg ae rganist,$ Cie
Dote of Fane il ae GP y. or Motor Tickets, $2 eT Service,$...]. 42. .
(Dai A (Day of ‘(GHour) Telegr., Phone, Cable or Radio Charges..... . .. A Ae
Ship f Remains to. 7 CPC, iil hare occ ee eeecces Cash Advanced....cccccccensccccccceecdscccccclecees:
Si Zt. w) wo Out of town Funeral Director’s Charges.... . ....]..ize of Casket 2722. eta efolop rs. era a Persorial Services. is che ponds vplees vets uw elvewelld ve cocwle wane
Manufactured by y Gort Pag opi treats CMe LG), Sil ose sear re eA fasta vies eRe ets oe
Cemete * . >,..line Death Noticesin... ADOIS bere; shecessll S aeete inelees ala
Sassy} ate “ici cas ct RIT CNC ERGs abe ac hel
(Names of Newspapers)
BS sd cE ay Soe wie Bin CE) a WF WW 5: SA ACaie ys gales cas auragnn s cc ah tas la‘h ont ea ca NBs bale «i
cou hepa ioe 8 deja ee Se elie
erring ane, aie Tare Total Footing of Bill..... 2.2.0.2. 000. $. 222. EP.
— Se Block No..... ee ee BOG a vse cap vee Res an sta alt oul ep $
Diagram of Lotor Vault OwMeien oo saotiee erent hme an eee site
Miscellaneous ew eee weer ee eee eee ese eee eee eee eee seeseeseeeseene Entered into Ledger page or below