HomeMy WebLinkAboutCemysmBK#4pg84-012184
Na. at NAME
lat'naeat
RECORD OF NURMENTS
Are SEX Social
Date of Death
PLACE OF BIRTHLAST RESIDENCE State
1'tan Alonlha Dap Year ,,Month Day
t
,yam>Z Z
,,.Q.� ��.L.Q.d4[:t�a.f�ll ..fGi-d✓RLQ..� : �� � .�r
9 ,
7 �G ! cdIC��JQi�fiJ, �.c.d1-0A.ckU
Z17
era
5`�'�n•
97j � L7
�M% /o
CITY OF CALDWELL, IDAHO
CAUSE OF DFAIll Data of Interment Place of Interment - - - — - -
Permit LOCATION CRAVE FEE
l Yar
Meath
Day
Section
Lot
MIZ
39
1o9
any
f3
es� wH
4fYfp
t
i 9 '61f/
tines:
i
�Or
ZZ
/ram
15
NAME OF UNDERTAKER
0
NEAREST RELATIVE Olt FRIEND
REMARKS
84
I