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Collection: Original Records > Death Records
Mortuary Records 1962-03 to 1963-06 - Index Included (331 pages)
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Page: of 331
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Total No.. ‘early No.. Date of Entry. 72Z ciel Pe Lae ae ee 94. &.
Name of Deceased. me ae a iad LTE. ee 5
fd Married 0 Single 0 Widowed iv ~ (What Race)
l/; Le A DHusband OWife QWidow)
Residence.! YAS et eee =. Vel 3 Paha wer s al Oe or. of Age of Husband or Wife (if living).. ... Years
Charge to..C.4Z. CLS.. Kis ie ene
so) lete Funeral (except outlays) .....--.--.se ee
Address.. Levidell a Ez. Peat Coe. Meta Para Zo.
Order given bY. 444.20 £4.4=@ ees Es rial Vault or Box. eer PR Oe MRA BS the
(or informant) tate Kini i.
How Secured.. & Rahn. nmeN, Sor ee, Oe Embalming Body ates Se ae Hr eeuatne vero
ue ew caede Bhs, Barber, $cc Hair Dressing, $2. 2 en
ee ; } Dressing Body, $....... Underwear,-Sive jo es
Secniiele es PMG TNL, se Mite ipelices nao) con DNS cr Ray Header . I to! ON UMMM as unccceaeremaele A lhe 5 SE eat
(Social Security Number) \ (State Kind and Color) .
Employer and 5! See ea: eC a eID oe als Slippersees 2 ti) Sea Hose, $ abe
ee" : :
Date of Death: LL4: 4 z YM ASL olding Chairs, $........Tarpaulin, $s
Lae Day) (Hour) Candelabrum, $......... Candles, $.. +}
Date of Birth. ere ee Zapsee bin LE. Door Spray, $..-.2-2.----0------Gloves, $ a"
CEE MO) =vs) . Funeral Car, $...-...------Ambulance, $ een
Name of Father. Cfj#Z, age ae og, SRR ge? ee Limousines to Cemetery...... CONE . SG AM ee ese 107 Io pak
His Birthplace.....-27-A1.OIF once ae) ee a Healer AL, Extra Limousines..... CGR cc ba ee ae
Autos to R. R. Station.. FEAR ae bare ad talaga conor 0
Maiden Name of Mother. Lé CALLS Geta emai tee ee ee ge ed
Her Birthplace._...... Hahn. SEA AO ee i ealeyng” PREIS Ose s! ea ft Loe case epee eal etoas
<4 Trip te Goroner selnquest) 5s See . gle
Date of Funeral..... reg ee” iy ol Weak 7 ipa Mi) tiitieering Box to; odie! nice ek hee
Services at. Lire IS. “Lae PLEO. te 7p P Higgs Desives GWG otcmiie, 0 en eset atl og tome 2 oe ater) et oN cee
cl Pilateetnoval Charees. ee a Lk deve! dens
is acpi on aces eames Rei IE thddtasties i! siecle Procuring Burial Permit.... ae RSET ee eer . Aa
Arey
(State Number an istrict)
Religion of the Deceased. ...-.----.-.sesss-cesseccensseneeteeeneeeetee] Certif. Copies of Death Certificates No ae A) AN . vl
(State sician’s or roner’s) i]
Birthplace. JE ig oer i EL sy Pall Bearer Service, $.... Use of Chapel oo
Hesdedin the-State Gross: 1 otalsfor Sales: Tax. e254 a . Ne so
on YS. of Outlay for Lot rah: SO a ASI
Place of Death IZLE: /“Cremation...2..2°..2. 0 peek . arias is © Ie Lh Eroredtanae via eas oe
Gauss of Destin. rap Ble Flowers, $.....-Palms, $......Matting, $..... Wal cosa ell
Rental of Tent, $....of Temporary Vault, $.... UL a ln lea
Contributory Causes. ie . Opening of Grave or Tomb...0..-.-.--2e0--eeceeeee eee . OE RE Ft
SB. _ LB Pe Sa ay Lining Grave, $...... Lowering Device, $...... ie ea inl
— he aid aden} Outlay for Shipping Charges 02.2.. eee eeeeeeee fee
Certifying Physician.. ft £ Clergyinen, $.2 2 Singers, $.... Organist, $.... lee SNR eo
i : Aero.
His Address. are 4 or Motor ; ‘Liekets, $.5..-2. plane Service, $.....-. tr Ne eo
Motor . p ; Helix Telegr., Phone, Cable or Radio Charges........ . anne BL Pe
Ship { emains to.444.0..; Cash Advanced. es FOP a
Size of Casket -¢_Out of town Funeral Director’s Charges........ A oacu. see uae
{State Color a .
Manufactured by.. fogs say oe, Bp. itis a aac a nee a . one ae
ees e Fee Wei, hn 2 ee ee line Death Notices in....... Papers....... SS ae
OGIO.) be a eee wh Se" (HamedicENewmbaperein fe a i ae ee ioe ee
Saption No nieactasan creme ot ee ea a eae Mears =
Total Footing of Bille eeeeeeeeeeeeeeeee ee $ £ZEIZ
Block Norte oi. Bese i Pee LS et Bhs _$
Dente.. 2. ee Balance (Uae Sora ke
Re Of ERE RENEE Entered into Ledger, page...... or below
EV ds aN ate ee: Ses ec, Os ee ie ae te ie . . an
FD sr eae ws base et asennad Sasa et aan Cea ease eseRnceet Es ete WG TSGees tees ee, cow he See lt atte Gt crm ge ee eee ed