HomeMy WebLinkAboutCemyBk2-pg79f•-
It
Block No.
Name
Residence
Certificate No.
Date Sold
Transferred to
So. oI .,AAIE OF DECEDENT
Interment
Let
Amt. Pald, $ Page
Deed Recorded Book
Date
Lot No. / Z
NO-
f-
v
Lot No. 1-3
Block No.
� �
Block
N D.
Lot No. I!
Block
Narne
Name
Name
I
Residence
`�
Amt, Paid, $ 1
Residence
Certifiento NO'
Deed Recorded Book
Residence
No.
Amt. Paid, $
Certificate No.
Amt. Paid, $
Date Sold
Date Nt
Certificate
Date Sold
Deed Recorded Book page
Date Sold
Deed Recorded Book Page
Transferred to
to
Date
Transferred to
I
Date
Transferred
I
AGE DATE OF DEATH
Se: Color CAUSE OF DEATS DATE OF INTERMENT PLACF. OF INTERMENT Grove
PNo.lt CFFee Nnme v! U Phy.lAer. Coroner, Nea"" Relative or Friend 8L^NAR%3
PLACE OF DEATH Year Alonth Day Block Lot or Phr•Idan
PLACE OF BIRTH Yea" Alontha Day
Year Atenlh Day t
I'll M42 . �^ / o .`19�z 29 j:i6z I 6 13 �� �� o° pPJ�Gtvt �G/ �°�) _
�Z 1?4z:1I .7/3� 3 (A)
P�� I _ .63
72�t �7 %1 /96 . lZ z7.3! 6 /fb �tJL "� n� yr W b3 ,t/ j 90 3 ! / l l / f / o o
o ,� l3: 6- '.2� 6� l �wN L 5 Y�-ey- an .
137y I : /3 �If 2t/ /%3 9 ~ /Q6� 9 6 % �v✓/fit I La
7� )
�540 va�,o-o•Q; C� t��Lt�sl. E2 7n .7�1 l`t�s� k . l%`5�. 6 o f!
C..I Q 7 a Z— w `W IKY, O/ �� ,
�. J7 `h� ?v— /96s! Y .z y . /�Eyl o . 2 6� G
�;Ilam�/' .
s1�
1
i
l
i..
1
V