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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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RECORD OF FUNERAL
Date of Entry. iy Potal NOe ee. Yearly ,No... PS ie AF 19. Lal
Name of eet Ze. CALA L. Zé. oe ViGD LMA Leb ee a Bey "h
OO Married oO oy Widowed (CO Divorced ie avr (What Race)
Residences? 22.04. Mia lactis MAT beg Dick ae ea a ee”
ok cde.
ni eat rae ae 2 he we ra age Funeral (except outlays).. 0.. . (eee as
Addre hE Seises LZ a Ce ee ee eis of £29
Order given by LUZ Gc. gle Te. nie ee Dee ee ae Burial Vault or Box CALL.. . . mw B.IPIO.
(or informant)
How Secured..
If Veteran, Name of War. AB. ee 2 A oe eee
Occupation. Laie beta bette EOE BBE: ee
(Social Security Number)
Emiployeriand Address: 5: eo oo ae eS ee Behe
Date of meee a ce Vee
0. ay r.) our
efx: ser =ee.
Date of Funeral 06.23 FZ. L2ua
Services at LES, s Use gt ec Niel ate yin ey eee
Clergyman.. IS ey es
Religion of the Deceased.....0..20.2202222--oe Sot ee
Birthplace LZLZQLM AL eevee
Resided in the State. GO GEE a
Place of Deaths / RIAs a ss Joys eciyy pfeil in
Cause of Death. LH ie CL.. ip i ae
Contributory Sai LOL LLL ACA ey, Lee meee LAE
De i ee Yes asTaz
Ge
£ Pn od VEE ee Catihy ying ae oo ea a
His Address. CLBLSE. Lee: do ee as 7 Je. wee
Motor R
Ship mains. to. 3 ee te oe el eet
Size of Casket.c2f2. > te be Pree ie aa re LIL
‘. Delivering Box to
al Kind)
.
Limousines to Cemetery. OF G5 Se ee .
Extra Limousines.. .-.-.0.. (OGG cite . Set ey
Autos to R. R. Station.. hs BE, Ga TE ra te ee
Getting Remains from..
Waline Memawentos. 8 al ee eles etl eenak .
"Trip: tontCoroner sal naiiest: — eo ee a
a hehe t Ce:
BS ODLE
Manufactured by.:
Cemetery t
Diagram of Lot or Vault
Einbalmuing iode;mcws mle el acs se I ke .
(Name of Embalmer) i
Barber cis.c.c ee Hair Dressing, $.....0.... . ee ae Pee PP
Dressing Body, $....... Waderwears Batt =. se). oe ile..
SUSE Rr Terese cre eee ae a, ne pe eee
q (State Kind and Color) \ .
Slippersoo i feos. ee PiasG. par nd ete Ae rently oe oa,
’ Folding Chairs, $........ Tarpaulin, $_. RIN Pew Sa ae
Candelabrum, $......... Candles, a oN Bee eel
Door Spray, $.......-.--.-Gloves, $. ou.. eee, sale et bea
Funeral Cara$2 soa: et Ambulance, ‘Sis oS ol he
DeliwerorminwersitOss. lee la Beye TE eee . Pe ee
Removali@harges. 3) Js sae i Eo) oe oe aks
Procuring -BurialPermite (eke ee ee his,
(State Number and District) . . ~
anal Certif. Copies of Death Certificates No..) 0)
: (State Physician's or Coroner’s) .
Pall Bearer Service, $..... Use of Chapel, $.....! [Field tie
Gross Total for Sales Tax. eeeeeeeeee . ate bolas
itay SOT LOtat 2 mee i Bll ee ee IR 3 sd ame l
Cremation Ae het eh A AEN . A Ia
Flowers, §.....-. Palms, §....:.. Matting, $..... ft See. oa
. Rental of Tent, $.... of Temporary Vault, $.. eit age PO
Opening of Grave or Tomb. pe ae ct \. _ SZ pe.
Lining Grave, $...... Lowering Davies. Saas . eee See
BBL S Shipping Charges. eee eee ee ee Ee
en, $..... Singers, $4 =“Organist, GN ge. 2a
Railroad { Aer
or Motor ( Tickets, $_..... plane Service, $...... . aes oe LL
Telegr., Phone, Cable or Radio Charges........ . _...0.00..-]..
Casnendveticeden can b-. ieen Wit Be SS eae
Out of town Funeral Director’s Charges......... ).2.2-.---.---. ------Personal oenvicgy (hea ro ee i aeons
ee ec ee ee ee ee Oe eee . oe see ee ea
fe line Death Notices in....... Paperad oh eo
(Nantes ol Newspaper. 2 Yl foe, a cin PL aah ee
Soice an ie ed ASE
PotalsPooting ofieil = oe eo ee $. . .727.
1 LYS an Age oles. a 5) . et POMiy alias <a See 0 $
Balance: 2.4 ee 8 . eels 1:
Entered into Ledger, page or below