16-31 Funeral Records February 1960.pdf - Google Drive

16 nate. ...... E.ehr.1l9..:ry...!±........:j....9..60

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FUNERAL RECORD OF Yearly No.................. :+..6.................

No............................_ _

Name.................................. LllDllie....E.l!'2ll.?i.Q....!.iJJD.:t;.lgY........................................Sex. ......!1)9:.;J,.~........... Addres.............................................lJ:e.i!~.!y.§..Y..•....A~lf.§:g.s..?:§............................. ~............................................ COunty.............~.~.P.:.~2E............Township ..................... _...................._..... Plwne No ............................ _...............

Where Born. .................._..i.xr...c.l.a.r.k ...c.Q.l.lnty-l-...l~!J.§.!?.Q!J.~t:Race............... ;:vg.:!:~.~ .................

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Date of Birth..........J..a!J..ld1lJ.'x....

J!±.•.....:l:.?!.9.../? ..........Age................... §~......_...._......................................... (Years)

(Months)

(Days)

How Long Resident in Community........................................... _........... _....................... __ .......................................... Single........... _...........Married..ID.a.r.TJ.~.9widowed ....................... Divorced ...................... Child ............................ Husband, Wite or Child of..........................P-ana;y: ... },!l,lntle.;y...... _............................ _................................... Address .........................................................................Gat.el!I.a.Y..,.... A..lJ;aD.!>.i&.§.............................................. Closest Relative..1!!e.t.ty.......1..l!.!.l.e....!?:Y.9..Y.!?L .............. .Addres •........ f:l.~ .;J,.~.glll.?-.~..! ....•~~.s..s..? .~.~.~ Father'. Name.......H.enry.....Hun.t .le.Y. ..................._.. _..::.Birthplace.............................................................. Mother's Maide'r¥ame.. .5UJ3.3!J. ...B.eng.e......,....................Birthplace..._........................................................ . Cause of

Death~~_~.....__ ...contributorY..... _.......... __ ..... _.... __ ............................

Date of Death ......F.eb.r.uar.y.... lj,.~ ....19.6.Q.......................Hour ... _........... 3..;.g.Q....A.,J~..,...........................

Plac~ ~f Deat~·r~Q~1i·:~nl!.2.S.:O'.i..~g.J .......................HOW Long Ill? s PhysIcIan .......................................................................................... Address ..................................................... Occupation of Deceased. ......... .Q.i?,.:f..~.~....§.~.~.~ .!:-.().l?: ..g .1/I.§.ft/;;1 Security No ....... ~2.?:.??:? Name of Employer.____ .. __ ........ __............................. _..__ .._.... ___ ... _.... _._._ ............._~._. __ .. _......__ ......................................... __ .. . Address ________ ...... ___ _. ____ ... _________.. _______ .__ .. _.......................................... __..... __ ... _______ .__ .__ .. __ ..___........................................... __ .__

·····Rog·ii·r·s·;. ·ArkaneiJ. Ir . . . .. ...?L..

Charge to ........Ins.Ul'.aD.QJL ............................................... _Address .................................................................. .

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Order Given By......l"l.1.f.sL..t;l..!)..Q,....g.?,l:\gh.~..~.r. .Address .................................................................. Date of Funeral... ... E.e.b.l::l.laa.. ..7.•....19.9..Q ....................Time ................................. ,1'..:}v.[ .:....................

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Place of Funeral Service.......G9...t.e.W .ay. ....A.X.ll.ll.r.;L.1......J2.9 0

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FUNERAL RECORD OF

.

No........ _.. _......_.._.._._ _

1S

Name....... _............................Ella....I.

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