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Collection: Original Records > Death Records
Mortuary Records 1914 to 1919 - Book 13 & 14 (310 pages)
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Page: of 310
(Total Number)
Name of Deceased..
Wite—Widow Bon-Daughter of ¢ "CL ht ttt tet eee e tesa een e eee ceeseueeeeseaes Charge to
we : Address 00.0.. cece ccc cee cec ce teeeeetecuueecues de deied
Order Given by v
How Secur / «. Price of Casket or Coffin € SiRiee 8 & Ba reiatw # B gieceieve & $ . . sa CHO.
perereee Date of Funeral.. ny,
Metallic Lining . helty Lic keens cores a
pt 20. Ct ea ssdnel savas Outside Box ... eli pages ve ass :
pte renee Place of Death.. Comdg easect fox L hated Swald § aoe “Grave Vault ...6.0. ss eseseee ees oe
Oo d —— ; (State kind)
b12.9 : Funeral Services at...B9QPD Acer cece eeccceeeees “Burial Robes.eeccec eee. Geaher veep e+
oy eeeees Time of Funeral Service.. A2@CKABA. 0.. cc. eee : 3 Burial Slippers and Hose. ..,...+..
eo ed Fra Kogravitig. Plate.. osssis is cadses sencedeccve ad . e
4A) 22 Clergyman .../.% ater, OL ona ie 5 ne ed gieiere a eahgreleiana Suleie Embalming Body (with
dl Certifying Physician ..Al%%~,.-W. & C&A: th s.. Washing and Dressing. ......0ccseeeceees oe
ost syns . His Residence .... UO par AA Shaving ee eo re ee
re ade: ; : . Keeping. Body on Ice......0.cceeveeeceeees
cn Number of Burial Certificate Disinfecting Rooms .....0.0seececeeeeeees
on eee Cause of Death.....:.0c.000. Use of Catafalque and Drapery ace snobs
Ses . cont . “Folding Chairs .........0ee eee eeee a
en eee Date of Death... PAAR.. APH Y L “ Candelabrum ‘and Candles... Le ceeeeeeeees a
A.\202 Date of Birth.. Gloves $....... wwe’ Crape: $i 5s wites.a ve saSais Speen
a ; Occupation of the Deceased T Aatd . Door Crape $...... Canopy $.....05i
Aen. OQ. Singl Married, .Modkavers Relivo: Hearse . 0.. eee cc cseeee scence eee eeteeeeeees 3
(n. 2.2 eT Me Ratti eS. Carriages to Cemetery,....@ $.....008
2 Ss
an Sa Aged..0.4=. Years, Automobiles to Cemetery
Seal Gana DURE GE Birth. ee e'einncgnis 44 siceniha btbatine cFummne voted he Wagon Deliveries ..... 14 0sseeseeeeee scans
. City Calis (Coaches)......0.c0ceeeucueees
a ‘ Name of Father........ccceteeeccceccceecceuns Death Notices in.....
a His Birthplace ......csecsseesseeeceeteeeeseeteeee Poo gcse Lapeahcnden Genial «oo Preanjenelbawatcans
N. f Mothe (Names of Newspapers)
a Name of Mother...... 0.. cc ccc ccececceeecesccuccen PUOWOES “ose sec cccegessececaesscanestecseecss He de] Eee
Fines tyson d Her Birthplace 1.0.0.0.. .cccecccccuceucecssseuceceece Outlay for Lote. cieco. esis ve cee ceed eendce oe 4).
Sla2 Mother’s Maiden Name........0ceeccececeeceeece Opening Grave or Vault...... SAE whe 9 Ries He nec .
ee ee . Lining Grave 2.0.0.0.. ccc cece ccc e cece ee cesenes
<a) a Body to be shipped to..... s+.. -s paw, Vault Rental .....0.0ccccscenceueseeeene
an en Size ahd Style of Casket or Coffin. .¢ Shipping Charges, prepaid: :
wesees . neem, f b. Saleiie(giniaie n 6 Sieidamens eeieeae geiemyis Sp peibibe’ Lad dierwelpce vutews le « Removal Charges
a Cremation Charges :
co. (ane Manufactured by ..4.2+2-secereessecsesseeaereesgeqenas “. POrters: oy. eiei's y eiedwuleecela estes peaswodsedeodhs satan gtAly
ae ene IQLONMIENE At.. evince esaecccesesssercdertbonds Cemetery. . Watchers ...5.5..0.6.000.eci fede fev oe dhe edits
evens . eneeaooone Lot or Grave No..... ef 8 eter Section No......005 Personal. Services. .. ‘ sreeteecestne
Wis s Music .. 006 esccseereeeeeetigeeeeeseeeneeten ee fl tg
VAL Lal 1, Church Charges .2...0.0 cic cceeeceeeeceees ake
. 2.
ii Sal 3. wiry! evuseass 4 pM ngh ts Es again feos dtrtede e
s * a 4. SPOS, © 6 OW OOS FS OSES e 0S Seca 6 a BEKO COs © 6/6700 0 & 6 G16 be
= = 6.
onwes : Total Footing of Bill. 6s.. 00cccceleceeeseee. $l KO:
nos [sions Diagram of Lotor Vaalt. ‘ : By Amount Paid in Advance........0004
: Designate all Graves in Lot with Numbers (1, 2, 8, 4, ete.), and ,
<a es mark space for this Funeral with a cross (+). Balance {
} esignate place for Monument with a small square ({}). . 1 , : ; i ae .
en eee “h in Lo} ng space to the right of Diagram for the names of those buried Entered into Ledger, page........0r below. . . .. .
aan : Io/b A :
ID OR.. 4 fue Jd. Total, $
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