HomeMy WebLinkAboutCemysmBK#4pg26-006326
I urn. lr:all r/."t5n L. IWr Ow,
RECORD OF INTERMENTS
Ne. of SARP. PLACE OF BIRTH
totrrmeat
I r
f � � ,0: .
vy4,;b
kAJQ�
I
i
20" V✓
R✓
� �A4
f
Age Date of Death
SEX I Social CAUSE OF Dl
LAST RESIDENCE - State
yen" Sloniha Dsp Year Month I Day
I
Jy C-3 J
z
h
Date of Interment Place of Interment
par Month
/4tv
H z
l%l .3 -
I9� �
Dal Seetlon I Lot
CITY
OF
CALMTLL,
IDAHO
PermitLOCATION GRAVE FEE
NAME OF UNDERTAKER
NEAREST RELATIVE OR FRIEND
l
i� C,87 /
Z 9
4,� 84W
�7 1p7 z�y//
-191
1e.Z
Z,�5 / 1�z
REMARKS
26
a
i