| STONE RECORD FOR: ___________________________________
CEMETERY ----BEING
READ IN:
________________________COUNTY_TWP Photo
# ____________ |
| |
| NAME(S) ON STONE |
| _____________________________________________________________________________________________________ |
| _____________________________________________________________________________________________________ |
_____________________________________________________________________________________________________
#
ON SIMPLE MAP DRAWN BY READERS ________________ ROW#__________________________
STONE#____________________ |
| INSCRIPTION OF STONE (CONTINUE ON REVERSE SIDE IF MORE ROOM
NEEDED |
| ___________________________________________________________________________________________________________________________________________________________________________ |
| ___________________________________________________________________________________________________________________________________________________________________________ |
| ___________________________________________________________________________________________________________________________________________________________________________ |
| ___________________________________________________________________________________________________________________________________________________________________________ |
___________________________________________________________________________________________________________________________________________________________________________
|
| VET FLAG HOLDER TYPE_________ (example WWII) AND/OR
OTHER AFFILIATIONS______________________________________________ |
| STONE TYPE: Table____ Head_____ Foot_____Tomb_______Funeral Home
Marker__________ Other Type i.e.. Mausoleum
_________________________________ |
| STONE MATERIAL IF KNOWN
_______________________________________________________________________________________ |
| STONE CONDITION: Good___ Fair ___Poor____ INSCRIPTION COND:
MINT____READABLE____ TRACES____ ILLEGIBLE_____ |
| OTHER COMMENTS ON STONE
CONDITION:_______________________________________________________________________________________________________________________________ |
| |
| DATE READ:_______________________________ READ
BY:_______________________________________ |