Obituaries

Elvin Henson
B: 1961-02-07
D: 2017-12-14
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Henson, Elvin
Jessie Powers
B: 1934-09-06
D: 2017-12-13
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Powers, Jessie
Sharon Lacey
B: 1939-05-20
D: 2017-12-03
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Lacey, Sharon
Patrick Monaghan
D: 2017-12-01
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Monaghan, Patrick
Patricia Enslinger
B: 1966-04-15
D: 2017-11-30
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Enslinger, Patricia
Emryss Jaquez
B: 2017-11-05
D: 2017-11-28
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Jaquez, Emryss
Christopher Martin-Longhofer
B: 1963-01-07
D: 2017-11-27
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Martin-Longhofer, Christopher
James Frick
B: 1944-04-30
D: 2017-11-26
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Frick, James
Susan Tucker
B: 1944-09-18
D: 2017-11-22
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Tucker, Susan
Angel Montiel
B: 1992-10-26
D: 2017-11-17
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Montiel, Angel
Anita Nichols
B: 1940-02-19
D: 2017-11-16
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Nichols, Anita
Florine Iverson
B: 1944-12-01
D: 2017-11-14
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Iverson, Florine
Michael Winkel
B: 1951-03-21
D: 2017-11-12
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Winkel, Michael
Brian Gandy
B: 1982-06-22
D: 2017-11-05
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Gandy, Brian
William Jamieson
B: 1960-02-09
D: 2017-11-02
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Jamieson, William
Windell Fallis
B: 1940-01-21
D: 2017-11-02
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Fallis, Windell
Dale Shumway
B: 1922-09-09
D: 2017-10-28
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Shumway, Dale
Aleta Smith
B: 1956-09-11
D: 2017-10-28
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Smith, Aleta
Sandra Wheeler
B: 2017-10-27
D: 2017-10-28
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Wheeler, Sandra
Joyce Newell
B: 1957-09-17
D: 2017-10-27
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Newell, Joyce
Johnny Jenkins
B: 1951-06-15
D: 2017-10-25
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Jenkins, Johnny

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528 N. Main Street
Hutchinson, KS 67501
Phone: (620) 662-6720
Fax: (620) 662-2546

Immediate Need

First, let us say that we are so sorry for your loss.

To report a death to Old Mission-Heritage Funeral Home & Cremation Services, please notify us first by phone at (620) 662-6720.

After that call, we will take your loved one into our care and will confirm a time/date for the arrangement conference. If you would prefer to expedite your time with our staff during that arrangement process, you may enter your loved one's basic information in this form below.


I. Informant Information

Full Name of Informant:
Relationship to Deceased:
Informant's Phone Number:
Informant's Email Address:

II. Decedent's Biographical Information

Full Name of Decedent:
Date of Death:
Decedent's Address:
City Name:
State:
Zip Code:
Telephone Number:
Date of Birth:
City of Birth:
State of Birth:
Highest Education Level:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names/Residence
Preceded Relatives
Occupation:
Industry:
Employer's Name:
Church Membership:
Club Affiliations:

III. Decedent's Military Record

Veteran:
Branch of Service:
Serial Number:
Date Enlisted:
Date of Discharge:
Rank at Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Cemetery Name:
Cemetery Location:

Miscellaneous Notes and Instructions:


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