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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
How? Sectired 91 6:2 ce PA CROP, MG Sven SEE peo es
NeiZ A y Lb: ; _
_ Clergyman Maths fx
' Certifying Physician _. Aha.
~ Body tobe shipped tos. v/0cjsscecceccneeccsseeteeesceeess
“ Size and Style of Casket or Coffin.. eevee eeeecee ee ee eee
eT ee weer ere emer seer er seers eawer ress tesrareeesrereenes
(Total Number)
Name of Deceased.
.Wife—Widow.
B8on-Daughter of
Dawe nt Funeral.. ‘Lap fpr cage
ice etoat. sheet OOO i UE aS vt
Funeral: Services a: Qe Se wi mane
Time of Funeral ae a7
His Residence . /
Number of Burial Certificate so 9 fceis tier sb cgae ee veins she
Cause ‘of Death vac ivinieuiies ceecg Soe See ete o6”
s (Prt [Secondary]
Date of Death.. Ci A
Date of Birth.. al A Serres
Occupation of ‘the Deceased, PASVIALAL EG Oe ae
Single or Married aad. ee ‘Rolelps Oo
‘Aged.c. eke. Wy Piece Fable see taie
Date of Birth.. icf
Name of Father: Xda a taf Ga
Filia: Birthplace tsic:. siceig lsisitias oods ow otitis Yelhe dena selec eds
Name of Mother culling Cokeey costes tGcss pieeuivehauees
. Her Birthplace RAIS e SN Sag, PRM iin? SAT a Tre
Mother’s Maiden Neediedebiic cee gee Sete ae
Gasser ees
CAAPIU. co ovices
» Designate all Graves in if with Numbers (ly 2, 8, 4, etc.), and
“mark space for this Faserals with a cross (+).
esignate place for Monument with a small equa’ re ( en
the neh of Degen for oe names soe: those baried
‘Church Charges
Price of Casket ‘or Coffin, 9000 ag
“ )MetallictLining.. 05.6. esses ee: a5
(State kind) * > ?
ae Citta Boil ee oe ecaes ce eee paemaies Juv
(State kind) j
f Grave Vault sais neces cirscesed aga te sible [Pudeiceruad
(State kind)
0.) Burial Robe. ce.. ee ee b eaten eee oie ie [aad dng
“
‘Burial Slippers and Hose. ...000++++
Engraving Plate .....++e+ee00s
Embalming’ Body (with: ...3....). Fluid)’
Washing and Dressing. is..sseeeceeseveeeeees
Shaving. COO ee Seeger eeedeegedengenyaoevenseee
Keeping Body on Ice......4-eeereeeeeseess
een eees
sAnce seneesnenee
sepennespateeged
Disinfecting Rooms ....5.+
Ube af Carstaloue anit Btapeey she ocean, Russie ad BN!
“ Folding Chairs ..,..c.ce cee ceeceseeeees
Candelabrum and Candles...,..+6-0
Gloves $..2.....Crape $..600 6.0 eee
Door Crape $....++«++ Canopy $... 0. eres
Carriages to’ Cemetery.....@ $...2--e00ee
Automobiles to Cemetery.. ..@ $.0.ceuecceeds
Wagon Deliveries ....-.:+seeeeer eer eeceeees
City Calls (Coaches) joosdersvenmtecaagss inet 4y
Death Notices it .uirh'y wy'ss Newapapers. « SEE oS ate Ge
sneeeneneees eoen
“
<snee snneensenens
ssevecepeserseess
tenes. seceeetonee!
ede CO meee meee meee es nee oe
a “(Names of Newspapers) . *
Flowers StGa teense sens coe eon te eay sree ene
Outlay for oe ee A etree
Opening Geave or Vatlt-.cvevssesengsteorvieds .
Vault Rental 2.i55:6.6:5 9:3 soe bsinigg cleidtt'e Se'sleeteedsS's
Shipping Charges, cpa Gee een
Removal ‘Charges 4.. + .-s0lginecies creeeeg cartes
Cremation Charges, ia
Porters). ois vies s'est
Watchers ’
Personal, Services
‘Music dvgakine
le eee Welle wee eH eine ee ee eee
Pe POs ee Te TT KS
Entered’ into mete page. .
oe ama
i Ban To Funeral Charges. 2.. Totals $ oe {. av. le BIE “By Cash}. 22. : me ‘ ny wee.$
sneeenseses sesewe: awwnres wener . rewesegeeeei nese . eedewene: iiesoes sesagoonses at i