HomeMy WebLinkAboutCemyBk2-pg211�
Lot No.
(
Lot No. t�
,�J
(
re
Block No.
�,.
�
Block No.
Block No. b
Lot No.
Name
Name
Name
Residence
Amt. Paid, $
Residence
$
Residence
Certificate No.
Deed Recorded Book
Certificate N o
Rt. corde
Deed
Deed Recorded Book
Certificate No,
Amt. Paid, 8
pate Sold
page y
Date
pate Sold
Date
Date Sold
Page
Deed Recorded Book
Transferred to
Transferred to
Transferred to
Date
ere*oe rc�ann. uto.uc. ,uxo enec PLACE OF DEATHNo. of NAME OF DECEDENT PLACE OF BIRTH
Interment
I
t
V
Page
Block No.
Name
Residence
Certificate No.
Date Sold
Transferred to
Lot No.
Amt. Paid, $
Deed Recorded Boole
Date
Page
I
AGE PLACE OF INTERMENT Gram Permit Genes
es Name of Undertaker, Conner, Neat Relator Friend REMARES
DATE OF DEATH DATE OP INTERMENT
—� Sex Color CAUSE OF DEATII Black Lot Na. Na, Fee or Physician
Year Month Dar Year Month Dal
Years Months Days
-
•
9{J -2-o° °.7�ifzzIl
G3 /1.� J� ��e.�� r 1.9• !�/ah.r,Y �m
(n �. � .�1 � uJ /958 1 /o C��t,t,c•eis. C,t�e-t.ft/ )�53 r /3 �� � °3-� ?0—�f
n �/J "'/1 a Cri.. [./fie 410— dQ.
!oU 11 to. Lv /,jS3 1 .�S ere.ks%r�l vaautUA i I�a'3 E =6
W / 9s 3 S c�
o
1.77
(F53 6 1 2 Z46 61 y /Soo
vd
l y6v. 7 z 66 .6 Po 6 Kum �s
2 C� tivk
/ 3 S- oa rf�
.3
67 b T ,W /96 'T
...2 '.�l '.� 'aJ /%b1' 1�:3/ 1f65, 3 . �• 6 .6 drS'lc��l 5.. a � �
3 h-
,
+ti