HomeMy WebLinkAboutCemyBk2-pg40r.
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Block No.
Name
Residence
Certificate No.
Date Sold
Transferred to
Lot No.
Amt. Paid, $
Deed Recorded Book
Date
canon roes}tat.4Wa[u. IFao Uu[ _'- No. of NAME OF DECEDENT
Interment
I
Page
Lot No. /
/
Lot No. / I
67 �—
Block No.
v
No.
Block No. Lot No. 1
Block
Name
140ma
Name
Residence
Residence
Amt. Paid, $
sidenco
Amt. Paid, $
Certificate No,
Recorded
tale No.
Certificate No. Amt. Paid, $
Date Sold
Deed Book
Page r
Cert�
gold
Deed Recorded Book P°ge
Date Sold Deed Recorded Book Page
Transferred to
Date
Date
to
Data
Transferred to Date
Transferred
v
It
-.__— - _ _.-------- - PLACE OF INTERMEN Cno, Permit Greve Name a[ Undertaker. Coroner,
AGE DATE OF DEATH DATE OF INTERMENT Nearest ReLan or Pdmd
E Sex Color CAUSE OF DEATH Lot Na Na. Fees or Physician
PLACE OF DEATH Year Month Day Year Month Day Block
PLACE OF BIRTH Yea, Months Days
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