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Collection: Original Records > Death Records

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

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0°9283 RECORD OF FUNERAL Total No.s.eeessssseee . Yeatly No. AS70000 Date of Entry.. Seer Bern.. L6..196 Name of Deceased. . Seba. Lh chal. A Neraag IS Ges weve clwle Mielpatolenets Lip 4 fe. tse Tele. () Married [Mf Single C1 Widowed D0 Divorced (What Race) Residence: . CA27k¥.; ALi ula 4) Cress Veallleeg.. ee of ip et ina se eo Oey esate a we. vg Age of Husband or Wife OR eee of Charge to: Mellen. MRO..ciccccccccal ae aac in. ; e Funeral (except ddvess.24-Biaxe.2 2S Met ado Complete Ronee (reept outlay Order given by. A Laos, elNOOR eee ene Burial RR orinforman If Veteran, Name of War. MiG.. Ss ecupation . 4 Occupation ALLE. outlays)...... apy EN eps kaon oe tate How Secured: : 4yeBOOS Leb nila wale ea. sis 6) Mb © Biss 6 aie 04) dlels (if living).....-.... Ye ieee ee Kin Embalming Body tenes ww ee oF ects Corer ee sitio scccne ccc cece cc eee oat . 2 . ¢ trees Hair a im Wi alleles = eh oP ressing Body, $..... nderwear,$.... . ....).. vec e vce ccceccuceseneeees , Dress.....bio Ketatoies fe fsicic Sicatity cute’ . Suitor Employer and Address ......ccccccccccecccccececs SlPPEPS $500k ws oe cs enale ETSY a oo ia ce ads ies Ball ine heey teres -y> /Ko ‘ Folding Chairs, $.... Marpawlln eG.. 4.3 o,u. lbnew sre eet Date of Death. Sz > 7 kh ees ie PE:At Candelabrum, $.... ANTICS 6 kenc! <8 Seah) a laus be wee he B" Date of Birth. . :7 oe A¢ lA TAge . Fr. ' spe, Ost We) (Wss.) .7.7F.. Door Spray, $..... Gloves, $k. (Mos) ls. Sed (Days) . Funeral Car, $.... Ambulance, $...../).... Services at.. WAGgOO Kt LOELUBE.cece Limousines to Cemetery... Ce en waive cad Clerpytiian : <tfZ.Frag c x. ot ee ea Extra Limousines ...... (G26 ; (Address) ene Seeded dy. aah «ae Autos to R. R. Station. ... (OGD cos coat Ss Miao erent. tile Religion of the Deceased. . a PLEO LOO Fe eee ees Getting Remains from..........0.{[e.cee0 [eee Birthplace . LEO LLé YL, : Ca : OF ee). Lae Taking Remains to.. 0.2.0.. 2 ee cee ee cee celle cece eedees Trip to Coroner's Inquest.. i.. 26.02. 22.0.5 ae sale. Resided in the State.. te rs Ste Beers! ois enate) even, Mabe sie ites (or U.S. or City or County) (Years) (Months) Delivering MSO TO es: te Deli Fl a
ee rl a pe Cause of Death. FO a Wee Mlda8eg. (LAS ere be Procuring Burial Permit. (State eedoor noak District) oss] s «sheave of @ oe earns Place of Death.“/H#+Arie. 02.. SPAS.. Pe ea ee Contributory Causes.....ceeeeeees eseeeeeeeeeeees ie ays ee see ft : are shelte : ae laa ote ahaa oct thas's PAO pee earer Service, $.. Useo pel,$... end ace Ars eth okt dale aSeame ery r. > Certifying Physician, Mea [Ker k heed.. Outlay for eer es His Address; ,. 2+. 2, He : . SF? fe fhe CROMIRIION . ios dig paver a gk eink ps5 Name of Father. 4Uh yaa vve ’ LIC, ro el i His Birthplace.. 2A. LE We ae ee 1 LAN o ae ans Si ettew ene thle Flowers, $... Palms, $.::::Matting, $...]. ....].. Rental of Tent, $..of Temporary Vault,$..\. .... . Opening of Grave or Tomb........./]....}.. rave A, a Lining Grave, $... Lowering Device, $... . .... Maiden Name of Mother. . 2 og ded be. Af la ‘?7.. Outlay for Shipping Charges. ........]]..../. : Her birthplace: . Colt. PR ieee a wing oe Mee ans Clean, et ~~ Singers, . gs Oreaniat,$ Aro Date of Funeral. S227 4,. PE@.,._/e eat (Da ‘Day of Week) oe F. toro fda. or Motor} Tickets, $2.00.. plans Serview$. oI. vc. .fess (Hour) Telegr., Phone, Cable or Radio Charges....]. .... .. Manufactured by .-S¥e-Z@ . .¢ ees, ee a Coneinbe 4 CZ o va GREE hole ie hc eel bs Kee as tt, ~7. 2. ..line Death Notices in... Papers ..../].... .. Ship a Remains to.....20ccceceeces bebe oltre we 5 Cash Advanced. ......sceeccecceecceell... lee. Size of Casket. 2.7. W. 7: Blue: LFnbSiR aes Out of town Funeral Director’s Charges.... /....).. we randeee PRPMINE AOEWIOD © cid sae oe oe rears vy a te nie Pater. cel rhaie LE alec thay aR ae line! ©tik’ on Oy eee aera Grave No...7 SPiN MEUM . , Steeabeten megs aha tFeaats lous) svn) ork ie'a'iete, slain] Wellals Ie © Scaeaceletalgie Ieamoee alate Ae Sata, Hi ee . Diagram of Lot or Vault Miscellaneous ddd Block No See a SOMO ROM 5 Hi dn ciule boa k ee cd is He we « veel kam « 3/7. ee, Total Footing of Bill........... $787. 142 Bee Less gu5) miss Owner. ..0.eeeeeee eee. $ Balance....... . a Entered into Ledger, page se ee ee