HomeMy WebLinkAboutCemyBook1-name+YOD01369 w
plods No.
pop
J
Lot No.
pmt. 1'+tid, S A9 n
turd Rccordnl Bonk
D:ae
Page � t
Block NO,
Namc -�
Residence
373
Certificate No.
,30� !y/r
Dnte Sold Ytd>I
Transferred to
co-C 3
i+, t
NANi ni' De.::.GAXT PLArt OF BIAIo PLACE OF DF.ATN
Y
Lot No.
Amt. Paid, $ /Z
Dced Recorded Book
Date
-_ _ --- Aos ---- DATE OF DEATH --
Sex Color
y,m MocaM [Ayr Year Mouth Day
1,07
L I a,, �nwd o. CasdweQA
?AA-
/J Oiny
0
56 R♦!a'fA„o.Cu„tort �/ fd httad� 13dac
A a Q clA v eIZ �u
0tlA. U
l I /
Page 14
CAUSE OF DEA771
Block No./ Y
l.ot No. /4 — S"
Name
Residence
Certificate No.
Amt. Paid, $
Date Sold
Dced Recorded Book
Transferred to
_ _ - Date
DATE OF INTERMENT FLAB OF INTERMENT
Grave Permit No. Grave Fee
7<n No.
Year Month Day Etook
f�
67
/I
z
I,l
/
K
/3
hi
u/
l2
/1-
-
Rw
GG
2—
d9
!9/
6
3
/Z
/9-27
.9
J127
7
7
VAt44,t <.ai
/z
—'xV
w
/9.AJ,
9
.361
t
r
t�
�23
Block No. / Y Lot No. G —
Name
Residence
Certificate No. Amt. Paid, $
Page Date Sold
D:crl Recorded Book Page
Transferred to Date
BlJt I l fu 7-1+1n to Wd�.., cA+u wt��4�f 6� afJ O 119/is/8
Name of Undertaker, Cora...
or Physician Nearest Relative or Friend
REMARKS
,
6
0 0 �-F CL4A:J X OLA-zj
'°
7g,
SL
Cr.
7�
/
/ 9