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RECORD OF INTERMENTS
Are Date of Death
SEX Seelai
Na. of NAME N.A(T DI' IIIRTII LAST RESIDFNI E Stale
Year
Inler�ept Mean Months Dara ar Month Dq
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I
CAUSE OF DEATS
Dale of Interment
i
Year
Month Day
7
/97
M
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lei
/(�jJ�
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41
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Place of Interment
CITY OF CALDNWLL, IDAHO
Permit LOCATION CRAVE FEE
Section Lot
jIA611Cy
LP2 �15r31;11f/
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NAME OF UNDERTAKER NEAREST RELATIVE OR FRIEND REMARKS
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CLIO"
00
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72
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