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HomeMy WebLinkAboutCemyBook1-name+YOD0193r p.: d ft.-rardcJ Book '` i�.: rt,_•et `Auz oe U u: ..83 Lot No. J jBlock No• `I Name Residence Amt. Paid, $ Certificate o• _ It cl Recorded Book Date Sold Page Date Transferred to - DATE OF DEATH ---'---_. AGE PLACE OF Ellin PLACE of DEATH Scan Sex !'oat:.t Dirt Color CAUSE OF DzATH Year Youth Day r2 f r f J f, o. aQ.d.w.e2� 9a G a o • .1 /q�8 7�✓�.���� � � 3 Block SO. 3% Namo Residence Certificate No' Date Sold Transferred to Lot No. Amt. Paid, $ aced Recorded Book Date Page Block No. Name Iesidence Certificate No. Date Sold Transferred to I.ot No. Amt. Paid, $ Deed Recorded Bock Date Pa ;'c ---DATE OF INTERMENT PLACE OF INTERMENT GNo10 Permit No. Grave Fee Name of Undertaker, Coroner Year Month nay Block rut or Physician Nearest Relative or Friend REMARKS !90'L- 'L Z iI? 2 6.Tu %! /tom_ 3 9 / � 9 39 2 e3 9 2 39 z /7 i Gt'�aX�• ea