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HomeMy WebLinkAboutCemyBk2-pg71Block No. 9 eel Name Residence Certificate No. Date sold Transferred to r.nae n tiN. weaiu �.� ••aia No. rf -ANE OF DECEDENT iniriaral Lot No. I Amt. Paid. $ Deed Recorded Book Date page Lot No. Block NO - Name Residence Amt. Paid, $ Certificate Ne• Deed Recorded Book Date Sold Date Transferred to Block Na Name Residence Certificate No• Dato Sold Transferred to Lot No. 16 Amt. Paid, $ Deed Recorded Book Date DATE OF DEATH DATE OF INTERMENT PLACE OF rNTERMENT GMM Permit Gnre AGE Set Color CAUSE OF DEATH Na No, Pee PLACE OF DEATH �— Year Month Dar ) year Month Day Block tat PLACE OF DIRTR Yese Months Days 2 /prsy 7 /J Au-A.94 P j AA 7/ 9 .7 z l?C5Y q Z r 19b? 9-f �. 7 11-3 l,/ ate, 7 ;e, 3 1 o?�p"'c���la,.Z Fix-t -s, �9✓` (.Z . /.3 i �. 7n � /�5� .2 '.3 6 X c '7 . .rpsy. ( .3r rym•01 r /9s1 3 io leap 3 z 6' 9 / nA i, 7W /939 j -2'v 1ps�; 5` « it /3 ay, 9 L z//rs y � � 2 6 -), /s5y 9 i- �� a i a /y ./9r1 �, l .z � �y 4-4 41 Page Block No. Lot No. Name Residence Certificate No. Amt. Paid, $ Date Sold Deed Recorded Book Page Transferred to Date Name of Undertaker. Coroner, Nearest Relative or Friend or Physician REMARKS k,