Mark DonaldHOLY SEPULCHER
SAINT MARY No. L ........ B ----- ---5 -------- D --------R--------
SAINT MARY MAGDALENE
CALVARY—Sta------------------------------- R ---------------- L__..----------- C
CHRIS IATA BURIAL CERTIFICATE
$l iG-------------------- CHURCH
Omaha, Nebr.---- .��$-------------------
cn
d
� �+__-•-_ ,_------•-- ----•---------- -
_______Family Name)
y (Christian Name in Full)
------------
-- -- -- -4-
(Street) -9--- -f- -L-rt City 1$a_._ (State)
------------------------------- Age--•--- ----
Born at
V
QDied at .---------- -----------------------------------------------------
z
--------------------------------------------
z
a
Date. of Death ------------------------------------
Causeof Death - i --------------------------------------- -
------
IS ENTITLED TO CHRISTIAN BURIAL
Date 'of x ra.L.- v tl._. a
..p.m.
:.......................a.m..----- (Hour)
Time of Funeral ----- --------(Hour)
at the above named church.
---
pastor.
Remarks: ----------
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OVER