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Name
Unit--Jz�
Block-
Lot.
Date of Mark-out
Date of Burial _Time
Name of Funeral HomeAuthorized by
-d
OOOPER., Emma G.
COOPIR, William H. (Interred) VcT ran
UNIT 2., Block 31., Lots 7., 8
William - Interred Lot 8 - 1977
Emma 7 - 12/28/87
. . . . . . . . . . . . . . . .
Paid by General Receipt No. Dated ........
Ust Price
....... Maximum No. Burial spaces ............
Discount $ .................. Total area in square feet ................
, --�
Net Paid $ ........ �: -,
... ...... Monument permitted .....................
(Data above this line for City Record only)