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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 FUNEKAL
Yearly No.. rs Hk SUE Se te Date of Entry.. ee on reba smeels 19
Name of Dec Foi meee Meee eel aral eta iararere jstiecstsi a s oneiettln1 se aistal onlay afc, 6) alehcmeebs eavicks Gale ain kel oneiovens Sa
o Divorced (What ced
Residence L7-. 3. ps Fe. pee = Lib TRARY, Lael taal nascent Kahan) bane yee
OP cas ce ageeeasseeees ° e 0! usband or Wife (if living).......... [<4
Charge to. Se Oe et Yo) a nO a a
Adds . A ve “y Complete Funeral (except outlays)...... $
ess. ‘ rmeiee Cetta) tad 4 Atle
aon eat le eo i ae L4ONC?.
Set gion ee BE 8 EET oon eee nes Burial Vault or Box ... aka pepe
or iniorman' tate in
Pinter cha cs « eth date cose Pals eke sie woot oh ea Embalming Body ... Gisele
ame of Embalmer)
If Veteran, Name of War.. 724.0000.. cc eee e ee ee ees in os Cee Hair pi rein we ee ee es
ressing Body,$..... nderwear,$...H....
Occupation Aire haotte...D@ ¥-222-8264) <. D
a FS ek ‘an Suit or BORG eee oo avant oe as eg ie ea eee es Lee . eaters
= a pret (State Kind an jor)
Employer and Address , = ha ftrck trip h BR sii) Slippers; $204.0 Sa cca sos TAOS) (bene ois te tebe «Scott ae « ore . Se
29 £7 2m. . Folding Chairs, $.... Farpavling S$. 5 5 tts] awada hla
Date of Death AB Y a. ‘ce (wr) 72: ‘Goi Candelabrum, $.... Gangdles,*$2.< cons abe es Sele E ke
Date of Birth’ LY Ce (£3 . Age 76.7.4/-.¢7.. Door Spray, $..... Gloves, $......,[-nce. ee} eee
y Pipi Wr.) (Yrs) (Mos.) (Days) . Funeral Car, $.... Ambulance, $..... . ....]--.
Services at. Xeigpadt 0. FLRAMEB A eee cece eens Limousines to Cemetery... Oise. Bells cling sraeccbe’
Clergyman “4 on ou Pa ere ope 2 ~ Ltade Vath: Extra Limousines ...... (Dy GPr ea cing Halas steal ees
ey (Address) Autos to R. R. Station. ... CE Sea es toad See MET yl fa
Religion of the Deceased.. 2421.0.. 0. cee ce eeeee es Getting Remains from...........{leceeeeefeeee
Birthplace. bi A Ace aE, ee eae. PRRINOWICOMALOS TG. WUE Seve Scie So lnceow cs Sealers ce w aie lees
ri ‘4 yi ‘ Trip to Coroner’s Inquest ........00c. lecceeeeleee
Resided in the State “to city er County) « "(Xears) a (Mon ths) s kaha Han val be dieu ghe sl STEEe, oe ane 415: 905 eae os silala ie & a: a
Place of Death. Aecre.cta. 62 te geek Sn waiiee. Removal Charges.....sseeeeeeseeeeeeillcc se.
Cause Olea tht red. 5 i) cle ie ccipubrt wiclalé.c sues bvinnyerddlaciietiete cag Procuring Burial Permit. (State Maiskkeb end Deion tees sy
umber an ict)
Contributory Causes..... Spe eb teal ducn. 5 oe Hoaeiieteeiecale sha! -s rote a Aare ae ft ie
earer Service, se 0 apel,$...
A deuce alebstalasercrers fgg e, sitidh tan Metso rete (ols ues Tete Wace: dantbrats ores CS Ee ee eee
Certifying Physician Cla thar. Ma hag Tas -s:. Outlay tie Lak WAR odes. keV 4548
lo : : PORATED 5. dss gl Nviclateee «sw ACEO ru oe whee oles D2 . oe
His Address. / Peg digg a fe ee Flowers, $... Palms, $... Matting, $...l}.... .Name of Father. Lbcthyje, eget! Dodi sce 5 olsPenalessleeae Rental of Tent, $..of Temporary Vault,$..!)....].Pa Ly Opening of Grave or Tomb.........)...-/e%
Hie Bathpince Pee ee yy Po me] cae Lining Grave, $... Lowering Device, $...]]....].-Maiden Name of = Sa Aiceg Aekbyeal apes Outlay for Shipping NGAGE Vid) Oe ga gee oa) RPM hee . . eee Pape
Clergyman,$<¢ = . Singers, .Or, t$755. Ale. 4 NAGE
Her Birthplace “= = se a ee) ee Katie tickets, $ inet eroag i
Date of Funeral fled, Quuwe.2 ome: CIS9-. L040. Zs, .M) % Motor ate na plane Service,$... .... -(Date (Day ot Week) (Hour) Telegr., Phone, Cable or Radio Charges....]. .... -ities Py Remains $0 Mie tai, he eo sees. Seat Gerdeda ges Cae AGURHOCE olsen Fahne a oh ella coeds
Size of Casket T/L 4 fa cA le. Out of town Funeral Director’s Charges....]. .... (State Me t.1 oe er fa Personal be. Moraes cece a aya dels S, OTRE eels te Salat] oe 5 ois
chan ee Ctehed CA.) athe, Hreruti, 727 ether.. iii.. 7 O24
wi . line Death Notices in... Papers: : . <2 ilass vat }eee
‘Gases are ener ie a peace Pastas Lease gee Sania en Mie We Vy. i sta ctedatahe vei Ieiecead orate neeo Sl audnelccoitas fates «aha rel] ore cave te ate
Lot No (Names of Newspapers)
Grave NWER. & Rn . a Ace
Section No D eGR LAR tetas chas cia etrelede alate cls ie at uated ea etter se ota
ea al ee Total Footing of Bill.........+..$]). LL2]%
me ae . ae, Block No..... esas PASS er scce dose stata tories stodto elds elale ity: elcvage: Steere seit $
Diagram of Lot or Vault Owens 50.5 o reds spe seas Batiiies AU tl at nae
Miscellaneous gisele es ¢: S14) 1b Sool bie ose otels) olalelerale @ elalarelsteieeterencik Entered into Ledger page... or below
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