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Collection: Original Records > Death Records

Mortuary Records 1962-03 to 1963-06 - Index Included (331 pages)

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2 RECORD OF FUNERAL Total No Yearly No. LEZ Date of Entry. 724...Z As eng i Name of Deceased.. Lidl. Girt Ge hhc. 0 Married OD Single pf Widowed O Divorced AE (What Race) >. : ; OHusband [JWife DWidow Residence Cu vie ZA Crk.. LEE. LES Oris. hédleg or. of Age of Husband or Wife (if living).. Years Charge to Locate CL ZL LZ C aT 1( slept F : / omplete Funeral (except outlays $ ph Mi bin Casket._2Z22-: 2 . 2« Cider given thy. Gesu ‘AL Ld alle oe Burial Vault or Box SOOM ich IS oo aL or informant) = tate Kind) How Secured fade, seleining mony. (NameofEmbalmer) ‘(. . . If Veteran, Name of War.. £2 Barber, $.......-Hair Dressing, $__.-___. ] ---------. -—ee ye Dressing Body, $....... Underwear, $222.00. ns: Occupation Cota ddea Dora. Sailor Dreta. 0 fo ee eS : (Social Securjty Number) 5 (State Kind and Color) Employer and Address LE LE ; Slippers, $ Fiakes Ghee Oh ea ee Date of Death ee 2h ALES. Laat oiding aaa eee js ope) caer mae Creme ea . (Day) (Yr.) (Hour) andelabrum, $.........Candies G20 it i Date of Birth 2A. ode 2 LE nt. Door Spray, $..2.2.-.0000+---Gloves, $.0 cal . . : y, : es ae aye)! Funeral Car, $000. Ambulance, $........---. . -.-.-------. ------Name of Father. £2 L.A LOY. Limousines to Cemetery. (Ope . . . ee His Birthplace Lv2g Lele =“ Extra Limousines OED ee a es ei ve lone. . Zz Autos to R. R. Station (Oy Oyo a Bree ee edad Maiden Name of Mother Lie a oer Getting Remains from.. -nsecncecneccsecceecoescoeecosee. . oocsocecosecoe[ eonee Her Birthplace 220 LA 3 "RAKING MRERAINS (Oke a ee ea oe : yu a Trip-to: Coroners Inquest Sesh ee ie Date of ea AE LL.. JAE Let aa M, Delving Boxtos eo we eg ew ae Services at.. @LQ2ALZ Lhd a. DeliveriPlowerstot 2 ator 8 a ee ; Removal Charges=.56 -leeee sd ig a Clergyman. AZze. es ‘. Procuring Burial Permit —— eae ee ae me (State Number and District Religion of the Deceased Bree RRS ae ee oa Certif. Copies of Death Certificates No.. Ud ieee Hae $ : (State Physician’s or ‘oner’s Birthplace. (2c. ee hc.. Pall Bearer Service, $..... Use of Chapel, $ Resided in the State fe Gross Total for Sales Tax ee ee _ (or US, er City oxCounty) Years), / (Monthsy . Outlay for Lot ceccseeecccseccneseeeneesenseesonecnne. . eccconaeeeneee scones Place of Death ALLE.. (slé.éél.tg UCAS, be > dae oie Cause of peath (Crebrred LEsat Z pase aia owers, $ Palms, $.... -Matting, $.. . : Bi’ Rental of Tent, $.... of Temporary Vault, $....]]_.....--. ... Contributory Cause: teal. AM Were bie Rateacaree Opening of Grave or Tomb .u.i..0222.2..-sseseceseeeee-. . -oeceeeeeeeeee. oeoeee Pep non pte S Lining Grave, $...... Lowering Device, $..2... . -0-.c0-ec+--. 0 ees Outlay for Shipping Charges, YE ee Certifying Physician.. C. OY. LJa: Lee, of Clergymen, §..... Singers, $.... Organist, $.... ]_......]... ‘ oe ee. g eae TAA Railroad { : Aero: His Address..<7:74AZLE. LL Gs (it tale or Motor § Tickets, $...... plane Service, $....02-. . -0...ec-eec-. o-o--Kotor q ie Telegr., Phone, Cable or Radio Charges........ . _...-.-----. -----. : Remains to Ship : ; Cash Advanced nse ee e ee e oa Size of Casket C o. wero ge Out of town Funeral Director’s Charges...-. . -.-----.----. -----(Stefte Color Number, 4 Servi Manufactured by SA aid COME. LB cauenac ae ek Rca ie eRe aor pat pera ieae e ae Conateesy t pe i ee oe Tt line Death Notices in Paners a Mi. . aks -Crematory. ae oa Beh “Dot nNo. L. (Muiries of Newspaperaly )-1 eta oe BO ee as ee ee eae ARK, fee Section No Sales Tax a Total Footing of Bill SUS? . Block No. Less $ ; GConee es ee Balance . EL A ae ee + ain, om fh gaa Entered into Ledger, page...... or below. isc .. Misc.