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Collection: Original Records > Death Records
Mortuary Records 1889 to 1895 - Book 2 & 3 (313 pages)

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Page: of 313

FUNERAL DIRECTORS REGISTER.
Total Number to date, Mf. cevsssseesete Funeral No. this year, Fefesone
AO . nn, yy Se Pe Lesi..Xears.
Date of Death, LAO ¢ Qa LA. 2 we 7Z..Months.
Name of Di . Keebler Lporssre
Place of death, ..
Residence,
Occupation,
Birth-place,
Name of Father, . His Birth-place, *
Name of Mother, .. . Her Birth-place, * ..
Duration,. ......----7
Cause of death, ‘ Primary,.
sf
Cause of death, Secondary,..~/ PU ect BOOP.
.. Duration,
Certifying Physician, £0, SG Nacecteeeey.
Place of burial,
Dace of burial, Se Ree eo
Funeral held at House, 09.. creer Gos
Put in the Diagram one mark like
. this I for every Grave in it. And mark
page < \ Ss
this Burial with double dagger thus : ¢.
{State whether White or Black. * Insert Town and State. Designate nite of Menamestshow:[7T]
ITEMS OF BILL. (Cross out items not furnished.)
Casket or Coffin No. cccenritissssenesseinaueieneenne Sle, : Od .
Length of Casket,
Box, Pine, Chestnut, Oak, Cedar or Mahogany,..
Robe, Shroud, or Dress Ne cccccceserrerreretOOLOYy..cseeseesenesneee Made DY ecseessccsssecssessnereecesenneesens
Timing Now ...s.--eeeseeeseeersseseeee Handles No. ne CP4Gr Plat No.
Time of Dressing,
Washing and laying out,
Embalming, ......-.
Hearse and 2428
_ccniusuufolding Chairs,
”
Delivering Box to Cemetery _.Use of Pedestals or Pall,
Badges for Bearers, ... Use of Candlesticks,
Bill to be charged to...
Date Bill was pr ted.
_.. Amount of Bill,
Time of Services, ne nee! May. cccecccseccsseeseeeeseene Forward from last page,
Amount forward to next page,
Copyrighted by Guo. W. Dornan, 1834.