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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 Me cc bins
Motal NOs nklicg ovine cues Yearly Nou.. 2.00845 Date of Entry... Rice Se Sanat idee ete 19.4
Name of Dssaned.: Pecan ee cw We dees Un Ren et lo a its Le 7 ee
AEP Married CO Single C1 Widowed LD Divorced “2 ve Race)
. : LT, . Mtoe’ Chetler Aiieadendl Stein . , Megs, CRATE es sso
Residence KEE. AAs eee. . fe ie "oo sa oe UES) Siew g of We of Hugband or Wife (if living)..ccesscooeu Yee
Charge obi ek gE ae fee n> ET 3 ee an ;
omplete Funeral (except outlays)......
Address. 227. £@. Cone. ee sg ah Casket. Ay. etree ees uh lve niece od Bee jee,
Order given by, : a Auxc/. ste tee cece eee wees Burial Vauitior Bow 244. ok. el eee be es Oedtlebises sone
i (orinformant) rE b 1 1 B q (State Kind)
How Secureds7 AERIS, 6 occ icc Selec ccc vevleswedlveel cess mbaiming body ... (Name it Boakeosee) # oe 9 ee 9 8 Oils e+ 8 ghe eG
If Veteran, Name of War.ZZ.. 22. e ccc cece cc ceeeees Barber, 9.5 3 wees Hair Dressing, $..... . .... ening
¢ _.,4 Dressing Body,$..... Underwear,$.... . .... :
Occupation Ylewtettaie 6.. Oe Ret Men Mere Sault bp Wiveee: eo. a. ck ee ee ce ones Weck i Ug,
Gosia! Becurity Nymlzer) (State Kind and Color)
Employer/and Address ...... cee eee eee e cece cence Slippers, $.5..e0 nels ses DORR IESG) Geo aie. pris, sed lade ote gis
Z ee a Folding Chairs, $.... arpaulinn gat fie: ais pa eee. anes 2.54 VI ,
Date of Death , /u+e ae 20. LET. rf ee Jig Candelabrum, $.... anaes. Stir, ces sal aiid D gies
Date of Birt) (4k 2% £589 Age L. 9.. 0%, Door Spray, $..... NC by ee ee, ae eke
(Mo.) Se Wr) Cire.) Mos.) . Days) . Funeral Car, $...%. Ambulance, $.....]].... Pip
Services at, ~ > age EPREEE ee eee ee ee ee ees Limousines to Cemetery... (iy siol Samak ern . . TEA Ey
Z , Extra Limousines ...... Gre vie hemlet a al
o db JR UMMELD GLI cee eee
Cima 0 es oe (Address) Autos to R. R. Station, ... (e. coer seat. ue
Religion of the Deceased Lobe Ce er ee Getting Remains from. .0. 6 f. 0 iw debe lsekc ie ood Wet
Birthplace ZZ, ep RRO eer, Bir al "TRIAOS, Remains £0 s.-. 6 ass cbs cee sd as v Soe elle oem a cae,
: we ot Trip to Coroner’s Inquest \...2.00..c0ceecle cesses .
Resided in the State “2. , Aedeeg, wee tee eee sence eee eens Delivering Box to is. soe. es hove ccclleouece:
4 ( .§ or City or County) (Years) (Months) Talines lowers i Pes at Deslcanss: Poorerde le digg . Deltas foo sccow ins nescence fotp hig emoval Charges abst Beene eee tees te eee eeealenceees aieeeid
Cause of Death Mpwucea Miltary. lleligy Procuring Burial Permit. . sid fiubet ‘eid hbk "CC eae
5 Y Certif.Copiesof Death CertificatesNo._dt.. . Lee.
Contrihutory Cawsesisis js asic p Sinus cuy asin ewe cats site dau (State Physician's or Coroner's)
Pall Bearer Service, $.. Use of Chapel, $...
a eee of[peerceereeeree re EL eoeeee Gross Total for Sales Tax ae doce peek ke ai aes’ $ rietes “E
Certifying Physician, roel. : Ae shrteh BoM.. CQGUAY TOR AE. gre us osu das UE ees Loves a ae es
Ath, Cy’ Cremation ee putters. Cet b0 sie cic ee ee, VENICE,
sities ‘ a Cag Ae Ae fe ee Flowers, $77. Palms, $: ::: .Matting, $... 1. PEIECS,
Name of F; P opt.. Chamced, Aur eae rene Rental of Tent, $..of Temporary Vault,$... . .... ile.
His Birthplace Aflieee L . Opening of Grave’ or’ Tomb. 33.5060 5 a3. 2 sails ais che ok
; : ‘ aha or ean wy kee oe Lining Grave, $... Lowering Device, $...\. .... as
Maiden Name of Mothern@/AZLe. theo AINE Slat ieee Outlay for Shipping Charges. eye spre lias, dey ai
Her birthplace: Clergyman,$€.<Singers,$.. .Organist, $7 oN. EES.
. * . Cr Railroad } Tickets $ AeroS = $
Date of Funera 421-06. Cn FEF 11. Fe. 72M) oF Motor fTickets, $.... ves Pui Siar . Gp areata a
Mien (Date) we (Diy of Week) (Hour) Telegr., Phone, Cable or Radio Charges..../. ..../.
Ship a POMS GO nes oC ons et iw 5 sic’ a eee aa RABE POVRNCOG OI EN «ce dis bass eg wae’ wee Spatalna nia.
Size of Casket 72. 42 hes ‘ es Out of town Funeral Director’s Charges.... . ,.... .
ee prigegang Gayo te < o Rede ee ee Beviotial Geryice, 6.5 5. is eevee Se cc ls SU et fr
Manufactured _b A, CA Kcflie GOE ioig . sche aE ieee Cage EW! Ni ae) rage ae
..line Death Notices in... Papers .... ligne Ae
Granstery } Wee sates Chetil) vrei, . rie Beal Neti in Aas Saale
Let hity.2 Shot orate ei LeMay, ata: atlngnasee . e ele by
} Gra? e No B55 Tee. beceueun ets ar geatic ep Oi taatae mat ShsbS Ne oe: o's) w 6) (9 8) ose e "6, 6hean go etm 6 Sree wis: aveld. ge -tull]s a cece pas cy
i i Bas Deere Cocca MEG cc se SSE
i oh et gine Total Footing of Bill.......0.000 005. 3 27 . Be
TAs GORE A oatr nce nee pee .
. Diagram of Lot or Vault ORIEE os si annv ee nb er 2 Papnee c.g a es a aay
MOOT OBIE gs 5 6 ccpscice vas oad ha dies coda oles CL uk Entered into Ledger, page... or hele.
SPS) WPA SAS at Nees 9.0 ef) SALE alee Ramo ce io ia sla Cav) 61 4 6 Sprig 4’ SGeS weds uence Miscellaneous