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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

22 RECORD OF FUNERAL Total No....0. Yearly No. 4Z3.. Date of Entry. Heng. Me beet ais 3 ate Name of Deceased. L£Z@¢74e< Ss aes CPCCA Gs 0s oi9)s odd esa fies Some tc aw'e ee Se OO Married CO Single BY Widowed “ “ (] Dyferced (What Race) : 7 ake as ec atecaed SVN PO ARE oo ea ca tk a ao ie ‘7° C. ee a Oe Sl ls of t Age of Husband or Wife (if living). harge t6/< ce KOM tahoe ied SMe Complete Funeral (except outlays)... — Address. AB, (Bar. F225. MAAK. . Ce ign “cag aoe —s SSCP = ' awe Order given bys4 Niece Go Sono ah ae Burial Vault or Box .. Pe ee . . ae T informan: . tate Kin How Secured Whee: shia Ig Mew gi cea oe ew ay aa UG Embalming Body .. hos mati tt eee te If Veteran, Name of War LL, Leeda dae, Rk Barber, Pere hs. hin Hair Dressing; $../].. ; i Zz Dressing Body,$... Underwear,$.. Via bare Occupation ORK 4s MOIS GE een ". Suitor Dress es leet <A fo. tee u MDP Er, (State Kind and Color) Employer and Address .. 0.00.00. ccecceeeceeece. Slippers, $.... BROGG ADs wl. . oonle ca tells ack y Folding Chairs, $.. Tarpaulin, $...]].. se? we » Date of Death ices. cae oe Gey feat a: Candelabrum, $.. Candles, $...0.H.0. Date of Birth <fech.o “SZ Age .7%.7.=.,. Door Spray,$... Cloves, Gia). ec. oe tk. ak _ 7 (Mo) (Day) _ Wr.) , %r8.) Mos.) (Days) . Pyneral Gar, Sole cul. Ambulance, $...]].. Services abe revacacate Ae teso nig Fort teense eee Limousines to Cemetery.. ee eee __ . Extra Limousines ... ROD oo fai ar bags lame ramen Oe ea Se (Address) ©" "°°" 7" Autos to R. R. Station. .. PSS. 6. BinahCuls Deen s Religion of the Deceased. “442.0000 e sec ecccceceeee Getting Remains from....... Birthplass , 5 OS ny, ae 2 Den Taking Remains to....00000000.100 0. “agp = ne arpa Ripon ay 9 Trip to Coroner’s Inquest ... Tals, 6 oI hy i i AO aa ca Le ee iveri Resided in the State. . nae Pipi pS ae ee ‘ih eae Ape cee sie Wis) . . Place of Death Prewcediec co. WA pik pe “. Removal SO tls ee oo ee ee Cause of Death Fa? Wiig bteok s patties Procuring Burial Permit......1.. : : (State Number and District) Contributory Causes a Ccenabecte, 6 Meacve. ea —Certif. Pama Death CertificatesNo.—— 8 at a “8 ew Zi Pall Bearer Service, $. Use of Chapel,$.. AA, WEIS COREE, veces : Zi : Gross Total for Sales Tax..... . ee cy Certifying OAtidac. M.A AEM. ORI ie SOR OR CS Loa) di5 9 Pag (Me lao ie i : a apg Oe Nee eR eI His Address f ehkaea. Ces ve Cocke et a afirie Flowers, $.. Palms, $.. Matting, '$. 010. Name of F: enlatclhaees Reeth he aesucels fe att Rental of Tent, $.of Temporary Vault,$./. .. ole Opening of Grave or Tomb...../].. His Birthplace. Zorg sis stare Cente We evel ae ea pea Lining Grave: Lowering Device, $. . . Maiden Name of Motieelif ecto, ---. Outlay for Shipping Charges..... ].. Her Birthplace why Simon ate ane te Clergyman,$.. Singers, “xc, Orwanist,$.. ue Date of : nen wer A ilttge Kan JRE, MJ oF Motor } Tickets, $72.2, =~. plane Service,$. .) 22. 1 (Date) (Daf of Week) (Hour) Telegr., Phone, Cable or Radio Charges../]. 2. seer } Remains to. Wieck ane, UMMM. A, ORE EVARCEE gy ceive v3.0 chd eh ese ws : ZY. Li y Out of town Funeral Director’s CR arang i adele os oat Size'ot Casket MA. ak Color he y aha Poragnal Service. 8.066 ec Seek ecde ig Manufactured by. .LepLceca.( Sa LAB ed dws ee 2 niall dnt Ricand accel yh adtoted MAIO Fu 9-5 Cometary .line Death Noticesin.. Paperai. 52d c dans en aA Pde SN SR ie eee Ag ae cr at Mg Rae ities SRS (Names of Newspapers Mot Mens Sie Le Oey ee ee the Wha mee a Woe ea a ae palace cy cer ies cogs ies i ie: hinge ak Dokal Footing.of Bill. oo. 020. $ ISL. ele Saas Block No ras gat =a ars tages: Less CLOTH le) #18 QpaNeG c0the olaih aie eles ese ee im wie Geo steel $ Diagram of Lot or Vault Owner @ div o'6 & bis Hd WE & © Boks) ws Balance: ce $ men fe Miscellaneous Be Oe Pee © OS eR Tel 06:< 6 yaa Ooo: aw m &Pete a ata! vce Sousa Entered inta T.edear nara aw hala

22 RECORD OF FUNERAL Total No.......0. Yearly No. 4Z3.... Date of Entry.. Heng. Me beet ais 3 ate Name of Deceased.. L£Z@¢74e< Ss aes CPCCA Gs 0s oi9)s odd esa fies Some tc aw'e ee Se OO Married CO Single BY Widowed “ “ (] Dyferced (What Race) : 7 ake as ec atecaed SVN PO ARE oo ea ca tk a ao ie ‘7° C. ee a Oe Sl ls of t Age of Husband or Wife (if living).. harge t6/< ce KOM tahoe ied SMe Complete Funeral (except outlays)...... — Address. AB, (Bar. F225. MAAK. . Ce ign “cag aoe —s SSCP = ' awe Order given bys4 Niece Go Sono ah ae Burial Vault or Box ... Pe ee . . ae T informan: . tate Kin How Secured Whee: shia Ig Mew gi cea oe ew ay aa UG Embalming Body ... hos mati tt eee te If Veteran, Name of War LL, Leeda dae, Rk Barber, Pere hs. hin Hair Dressing; $..../]... ; i Zz Dressing Body,$..... Underwear,$... Via bare Occupation ORK 4s MOIS GE een ". Suitor Dress es leet <A fo.. tee u MDP Er, (State Kind and Color) Employer and Address .... 0.00.00. ccecceeeceeece. Slippers, $....... BROGG ADs wl. . oonle ca tells ack y Folding Chairs, $.... Tarpaulin, $.....]]... se? we » Date of Death ices. cae oe Gey feat a: Candelabrum, $.... Candles, $.....0.H.0.. Date of Birth <fech.o “SZ Age .7%..7..=.,. Door Spray,$..... Cloves, Gia). ec. oe tk. ak _ 7 (Mo) (Day) _ Wr.) , %r8.) Mos.) (Days) . Pyneral Gar, Sole cul. Ambulance, $.....]]... Services abe revacacate Ae teso nig Fort teense eee Limousines to Cemetery... ee eee __ . Extra Limousines ...... ROD oo fai ar bags lame ramen Oe ea Se (Address) ©" "°°" 7" Autos to R. R. Station. ... PSS. 6. BinahCuls Deen s Religion of the Deceased. “442.0000 e sec ecccceceeee Getting Remains from.............. Birthplass , 5 OS ny, ae 2 Den Taking Remains to........00000000.100 0.. “agp = ne arpa Ripon ay 9 Trip to Coroner’s Inquest ...... Tals, 6 oI hy i i AO aa ca Le ee iveri Resided in the State. . nae Pipi pS ae ee ‘ih eae Ape cee sie Wis) . . Place of Death Prewcediec co. WA pik pe “. Removal SO tls ee oo ee ee Cause of Death Fa? Wiig bteok s patties Procuring Burial Permit...........1... : : (State Number and District) Contributory Causes a Ccenabecte, 6 Meacve. ea —Certif. Pama Death CertificatesNo.—— 8 at a “8 ew Zi Pall Bearer Service, $.. Use of Chapel,$... AA, WEIS COREE, veces : Zi : Gross Total for Sales Tax.......... . ee cy Certifying OAtidac. M.A AEM.. ORI ie SOR OR CS Loa) di5 9 Pag (Me lao ie i : a apg Oe Nee eR eI His Address f ehkaea. Ces ve Cocke et a afirie Flowers, $... Palms, $... Matting, '$.. 010.. Name of F: enlatclhaees Reeth he aesucels fe att Rental of Tent, $..of Temporary Vault,$../. .... ole Opening of Grave or Tomb........./].... His Birthplace. Zorg sis stare Cente We evel ae ea pea Lining Grave: Lowering Device, $.. . . Maiden Name of Motieelif ecto, ---. Outlay for Shipping Charges......... ].... Her Birthplace why Simon ate ane te Clergyman,$... Singers, “xc, Orwanist,$... ue Date of : nen wer A ilttge Kan JRE, MJ oF Motor } Tickets, $72.2, =~. plane Service,$. ..) 22. 1 (Date) (Daf of Week) (Hour) Telegr., Phone, Cable or Radio Charges..../].. 2. seer } Remains to. Wieck ane, UMMM. A, ORE EVARCEE gy ceive v3.0 chd eh ese ws : ZY. Li y Out of town Funeral Director’s CR arang i adele os oat Size'ot Casket MA.. ak Color he y aha Poragnal Service. 8.066 ec Seek ecde ig Manufactured by. .LepLceca..( Sa LAB ed dws ee 2 niall dnt Ricand accel yh adtoted MAIO Fu 9-5 Cometary ..line Death Noticesin... Paperai.. 52d c dans en aA Pde SN SR ie eee Ag ae cr at Mg Rae ities SRS (Names of Newspapers Mot Mens Sie Le Oey ee ee the Wha mee a Woe ea a ae palace cy cer ies cogs ies i ie: hinge ak Dokal Footing.of Bill.. oo.. 020. $ ISL. ele Saas Block No ras gat =a ars tages: Less CLOTH le) #18 QpaNeG c0the olaih aie eles ese ee im wie Geo steel $ Diagram of Lot or Vault Owner @ div o'6 & bis Hd WE & © Boks) ws Balance: ce $ men fe Miscellaneous Be Oe Pee © OS eR Tel 06:< 6 yaa Ooo: aw m &Pete a ata! vce Sousa Entered inta T.edear nara aw hala

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

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

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