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Collection: Original Records > Death Records

Mortuary Records 1914 to 1919 - Book 13 & 14 (310 pages)

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“RECORD OF FUNERAL. GAG.. No.. 29.. 6.0.05 Date. ior Auteap... A Name of Deceased.. Wite—Witow F Saud Penton. Son-Daugkter ot LOL vececens a ade Boe Caf, Charge to A. a 4, _ Address Order Given. byes ne .sadins ss ciccditle s siiesca becsnde ccgsineelsies ete, : LI t ‘ . bela.. ‘ 4 JA Hows Setured . isis siginisie os visa isiaa semsie.s os aawiecsceaaaine « vdie Price of nig rn tteteeee beaten eeeeees $ £20 Date of Funeral. ,.¢ Residence .. / (Abi e obsli'salncy suman oae pcidiaiiiniel “isos Place of Death.. Diao, EZ.aig tamed st Recseran qgeaie hdd, cotiene covets Burial: Robe ‘v.06. ecceeves 2. eg Schade *f ; Burial Slippers and Hose.......rneen fl ‘ Bngraviing Plate.. Zz. . : “Grave Vault ...ie Lp stains j werner seecainal Funeral Services at. Re: /. Ulu,fare. pea PNB Time of Funeral: Service.’: Jes a, t's aise ois o & ciara . ) asssoced siegeASN Onttside: Box .s:sieiegeri 4sreel WARP.. Sou ldighias Se vsjeicisa > Lelwaiwls says escces asics so seseis « osicisigia se . . scherees stein Clergyman .. Mga ft Embalming Body (with...... mE seta Fluid) . . <2, Certifying Physician . A¥-K. His Residence ...% (22 Le 4. : ia . . Number of Burial Certificate Cause of Death........0.4. ge y siaverasae 0 8 sheriheise momwisye Washing and Dressing......s0eeeeeeeeeees aa eons having); « Skuisiis « sedge 5 cimping 0s Sireiewe 6 a wiaionn as [lrahiostleacsos , Keeping Body on Ice..... ccc cesee ee eeeneee Disinfecting Rooms ......Ge ceeceeeeeees a Use of Catafalque and Drapery. ..... 065000 Wess csseeceeen Primary) [Secondary] Date of Death.. Mifae: : +%y OLA.oye. * eters meee Date of Birth.. et
SWYGL PD.. cccevecsee Occupation of the Deceased. Gf.SZ “ Folding Chairs ....... “aid “ d Y sslelid & § BAheaonrenaie Candelabrum and Candles........45 see ote} pie b piace tale’ Single or Married. Liege. Religion. litle,. Carriages to Cemetery.. eae GP.. Ahead /; can Years,/..3. . Months,..Af ..Days. . Automobiles to Cemetery Aged.. Date of Birth. ....200ecepeccegecceceseeeseetssesens Wagon Ap esiar Peete ee ee eee etna een ee ee ees Name of Father. EM. hissed 5 5 sree His Birthplace .... City Calls (Coaches) Beth Notives-in. .:.2.. P 4 Name of Mother..... : Flowers 0.0.00.. ccc ccc ec ee cee eeeesteeeeueeaes a Her Birthplace ... A Outlay for Lot Mother’s Maiden Name. Opening Grave or Vault.......cceeeeeeees Pare3 Body to be shipped to....foecccscecreefrvecsccaceres Lining Grave .....0csce ee eeesPreys 4 9 atereee view a & Vault Rental ...cccccceccccccsccecicecenees ae wut Lira, en foldUae..” \Removal Charges Size and Style of Casket or Coffin Shipping Charges, prepaid......06 0.00000 . ccccsssnseen ; Manufactured Cremation Charges Pee ce 5 ohn good ihe oie ores oes wnench ade ae by ..,..-.eeeee0wince 6 « ajeceints a seers Interment at.. a ; Watchers ...sceceeceeeee Kpcaro ny » {bbe ¥ sieietbs esas tabeseaes Lot or Grave No........ Section No:.... rit Personal Services cis de igitleng qreinisicies « as pigitieey oswise'Tl tips Wet gnc tS Tees, MRM RSG ggg baicats pm mtesied piped depos 2 3. 4. 6. $ Diagram of Lot or Vault. Designate all Graves in Lot with Numbers (1, 2, 8, 4, etc.), and mark space for this Funeral with a cross (# ignate place for Monument with a small square Use Hoece the right of Diagram for the names of ee, buried ads 77 Mpa. 2.. (To Funeral Charges... Total,$ . 27ANZ.PA Vanes of) Pal? Roaron = Total Footing of Bill....2..00e.005 See AIA By Amount Paid in Advance.......0s0006 a ‘ i Balance... He anaidiaiie: a BAe ee are thes sé ore Hansbivace ; t