HomeMy WebLinkAboutCemyBook1-name+YOD0176Lot No, / o
I,ot No.
raid, $
U.,.1 e,,,,rdni Bonk
Date
149i Of Di!ELEKT PLACE of Baru
Page
Block N0• -_7
Name
Residence
Certificate No.
Date Sold
Transferred to
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PLACE OF DEATH
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Amt. Paid, $ Deed -Recorded Recorded Book
Date Page
J .,s
Block No.
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t certificate No.
Bate Sold
Transferred 10
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Lot No. //'
Amt. Paid, $
Deed Recorded Book
Date
Page
Block No. 7 ,,-
Namo / 4 r . Lot No.
Residence
Certificate No.
Date So
�11 ^ 367 Amt. Paid, $ J
Tranatelde
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do g,Z! r Deed Recorded Book / Page 1.2� �
G,.A'I...tt Date
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AGE DATE of DEATH t __ - -- Sex Color Color t. DATE or INTEnIENT PLACE O! INTERMENT - - -
CAUSE OF DEA Grave Permit No. Grave Fee Name of Undertaker, Caraner
Yon !.{,nUs Dsys Year Dtoot6 D No. Nearest Relative or F[icnd
'% Ynr MoerE pan, Block Lot or Physician
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