HomeMy WebLinkAboutCemyBook1-name+YOD0088lk
Block 1`
Name
Rt 4dent
Ctriific;
I ; Sol
(;. infer
J,nt No.
Diodf No. aaJJ
Tame rl xwN
RE'idence AnA. paid,
Ctrtir,c:de No. �G peed Recordtd Bonk 1
Bat,: Sold Yt� I b l i pate
Transferred to
Block No; ,
`� .. Lo
Name .. �.� 9 _ t No
Residence e 7�`
� Certificate No. /_ J" %
f
Date sofLi''� / 9� D AQd r11d 8 �o
Page
D,� RB o
Transferred to ecorded
Date
i:AIfE OF DECEDENT PLcs OF BiRTn PLAU OF DEATit
/ Q 0 / Ana et PvG�
qor IAI�V i IP 7/.3rl�uLA c�L.'wistcw• t�otou rt LaJ U
/0 'ApUrAgj, 1, i o-,u; lrtJaJt d/ /Q� T3a-i,c u
�1�• 161 '1
��kl � / ' ✓� �I'I,�r�,tea�, tt
3/ y� 3 c qa .
HHo�
ri
ram,
AGE DATE
Sex Color =�
Years Afomhs Days
Year month Day
r
Block No. S^ Lot No,
Namc
Residence
Certificate No. Amt. Paid, $ J\� O
Date, Sold j : / % / O Ticcd Recorded Book /
Transferred to _ _ Date
A tt I -__ - -
C) ., DATE OF INTERMENT PLACE OP INTERMENT
Block No. 13- Lot No. _-2 0
Name �- �/�Z
-r
ResidenceG
Certificate No. Amt. / /r'•`/
/ Paid, $ ��
Page Date Sold
5r /f' / U Dced Recorded Boole
Transferred to Date
gr-4
Page 6 �7
Grave permit No. Grave Fee Name of Undertaker, Coroner
Ynr Maath Dar Block t.ot No. or Physician Nearest Relative or Fritnd REMARKS
7.
G 2 5
9/ 7 .ho3L 13 ;7 0 3 � a o � �P. ,cp _;rew .
S 7 /Y rrt /%/9__ . 30 , , /9/7 h.r /d tS /7 � /a0 3 00 � y
y 4 d�• s b (�° /� �1 �•�T.'r* �llJtL P�
-- so-� -- -
I /szy 3.-/z --� /6 ago .7 �-G t
73 9 /S /-yip_ a� h 11� 1
t �I:1�C /y.29 .. 3 . � D .---'`1 - /� S — 3 / --- --10 e o_ �MA•-Y/ e1• �aa_e. - - -- ,EQ_-.�i-r.�t/ _.
5L4 - -
/y3/ %l G eoc; :. /141 //-- /0-- s - ao . �---!�v1a_° G0_?J..�t'�cfe�u
m4 / l ��- dur'r i4'a : I M4 . /-7
-
3
� / 3 /o oa J �
/ %� / _'�°� C%r.s �r� o r' _.rex / �c/fe�z C� t 1�
�
�l 21 W /99 �y. �vJA.r� Mroc 19�3 1 j' a �o o 2 3/t�TJ n II11
�` I / o .y p V 't z�
, tiJ p,
3� � — �-vi u� l�y� J� � � /y��-/s__�a �' ct _gi`.��"" /o_a.v.�.t:ti4Gitcl�sa�r.tU.tk-rGtc �. �•07 _
52 // - 14 . it) /9',4 �r / � . / d -. — �� ' l `1�J %' / -hr Z ` . la oz r / o �-e�
/a pe— "
to
� n3- W i9y9
T 0j,p c7 ��_ e �✓
J t h %l?s <9 y E
t.