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Unit
Block 3
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Lot - EA
Date of Mark-out Ids "Co"
Date of Burial Time /0
Name of Funeral Home A, Ae4
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152 April 24, 1973 Deed # 203
Paid by General Receipt No. Dated
150. Charles C. and
List Price $ Maximum No. Burial spaces 2 Irene 1. Tice
-r-
Discount $ Total area in square feet 312 Pineapple St.
150.00 (ck)
Net Paid $ Monument permitted Fiat Sebastian
blk 35, lots 27 & 28, unit 1
(Data above this line for City Record only)