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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
ww \ ~ 35 — RECORD OF FUNERAL
Tetel Now. cc's «se ¥ecde Yearly No.2.. @..0.00. Date of Entry... ee Bey gs. 19>
Name of Deceased.. LAL. Arrage. Mipadecrced Sr M Nea aso cakoum elie E xiein alts a. ule Li AtHE,..
(C) Macried CO Single pt ‘dowed OD Divorced (What Race)
Residence.779.9, CLewee. AB: Pees, La teuonuscte , Maly. ot ee ee sis Baie Fe Wg dW aati leita adie ganas
OP stasieveutnee anaes of Age of Husband or Wife (if living).. Y
Charge to 4 Ubeporernas oe Che cas ettea BO. Uie: ome’ eseae le) ols (6) aw kone C 1 t Fu 1 t tl
omplete Fun peers Bosh 163. aoe Z lasheryp cel aie aan era exer outlays)...... $ —.
Order given by. tenia. Abas aet 2 aR Burial Vault or Box . .C¢-2xext_Le xers.. . .. skaee
PLOW SOCUIEOE ctl ala 3 ane ook Sale ginal vie ni toute wap UL aeeA Embalming Body .... eae Chieti aad Oe gel hm
(Name of Embalmer)
If Veteran, Name of War. 2. .. 0. cece cece cc cce ccc cee ee ss : ¢ eae Hair Pa eat 8 es . nnn ssi
; bic! ressing Body, $... Seether nderwear,$...H...cJe0.
Occupation Ah bttatcrrigft’ trees saa ee . Saitor Dress. 02.4.0, = Crvacttr.....1.. a¥. KH
(State Kind and Color
Employer and Address . LS Ae Slippers, $....... Hose, $.. Fa eee Lea te
SH Folding Chairs, $.... Tarpaulifi, $05. cc los, aka don
Date of Death i 4 ae i Beets * a Candelabrum, $.... Candles, 3.58.52 2 dhe ded ot
Date of BirthQuune. 25, 6F/..Age.67..47..9.,. Door Spray,$..... Glovety Gs j.¥.5 Fo oso flea coe es ie
. , ilo.) ae Wr.) Cre) Gos.) (Days) . Funeral Car, $:.... Ambulance, $...../1....]..
Services at. A@aneits <A CEM. 2. ic Bs Siesta ee Limousines to Cemetery.. . Oe ii ea ats . . Rae =
Cler Be a bre, Ba Pie, lg Lapa, Ze Extra Limousines ...... Ge es ites he oes ie,
sym y (Address) Autos to R. R. Station. ... GB ae eles ll eae
Religion of the Deceased. . . 244. uC TOPE Bhi Getting Remains from...........]].... a
Birthplace 772 PER GL” ih taal Career Taking Remains to.............l.... ae
ig 9 Trip to Coroner’s Inquest ..........]....]..
Resided in the State.. 7 ita! out "Gey Oe Delivering Box to 2 sigftireas . ipsa wa SPR yh ete wee
i ici sos. 4 das oie Mele te ml OL Ue eee oa
Place of Death, »A¢ tte on+ete. Co. Rageetal.... Removal Charges.........-ceeeeeeel...
Cause of Death: .o ipieteip Sane sias & she eee oiods du aigiel onaterd Hoetteus Procuring Burial Permit.. . Nimbes aus Deka et Aes °
A A ‘uml ani istrict: =
5 ) C 3 Certif. Copiesof Death CertificatesNo am . e aes
ontri utory DUES piare: «vs cisiace /eisie-vivle.¥e 6 eele emiviete ae cieeié 1 (State Physician’s or Coroner's)
Pall Bearer Service, $.. Use of Chapel,$...
a’ ? : Ste al t : as aaa eee eke eles Gross Total for Sales Tax.......... . ee ee was
Certifying Physician...... page es ners sata e's ah Outlay for Lot. ..0/.€:A:.64-4%..... ]] ZS. 22
RAROEOUECIOTN 20h 8 Siceg «Ens Ey oh cece ht ig
PAIS AGGPCRS. = Covicoslel scdis glee a cgtes, «ne ve eleieeeua ode ce Flowers, $252 ‘Palwecn Matting, $.. ieee &
Name of Father. bjyaani<e4 BA raabrnbiiesk Wekeneibereantans Rental of Tent, $..of Temporary Vault,$../].... ay
His Birthplace. ...... Lest hacer oocccecces. 0 pening of Grave or Tomb.. 0.2.0.. ee Hess ied Ros
2 Lining Grave, $... Lowering Device,$...]. ....]..
Maiden Name of Mother. 7244. 4.4. Cbeacuplar ds. --. Outlay for Shipping Charges.........].... .
Her Birthplace..,,..: Ze A AAEOUL, ooo ee censs Cie riae, 20. ‘Singers,$%-. Organist, $: cee eee Dee
0: ° .
Date of ics ether: by IEF.. F320. em\ % Motor} Tickets, $09.. plane Service,$...!.... = a
(Date) ” 7 (Day of Week) (Hour) Telegr., Phone, Cable or Radio Charges..... . .... .
Motor . BReraARA BO Pe is. 68 Pokey Unley enae ven waach wee: RE OVEOUO LF tes nes hehe eevee cl .,
Size of Casket 9°749, 44 "Ae bins Bets . eee Out of town Funeral Director’s Charges....]. .... any
(State Color ead. Nasaber} PormoparRarvite. n. 6. ai, . ci cus wees le towel see de
Manufactured by Cakheaceks. lechst, Cr, es cwesty alah up ues = pacenaiers D274 fee) Co ee ees ecwrecereceves .. 4P1L°
Senties \ WER. Le ..line Death Notices in... PATS. ocoks Ne ace es ah
ponte So et ee a ce ca age eg eat
Grave No. hai & Z oe Belted a, aie t i ee ee OP ONC Se 8! oeiene-e S @28 ie baie we WA's sb vile pf 0 ehPeub are ioe: ¥
a Ley NON DUS e oe dn sine bok Lg ake cat wie Sa ee, ZA \SE
Ce neem sees Total Footing of Bill........... $.772. .22
. . Block Now.. 5655 iat Re ont eis $
Diagram of Lot or Vault Owner. .......2005. Balanee. oo. 3.5 ovin cn . ee ae eee
DEC OI o oss HE slo ees wes 2 enya ae Entered into Ledger, page... or below.
Sfatratel oipr'e (ohiSt a: Bevanaly aa: 9 Gig: 9 Semrete Eola) acR ies a Meera ere tucab antes te ek ue ee UE Ts Ue, ae ne ea Pe