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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
LIE . No Zo Fic yp NOB ”””~*«C ate RPA. bof Ack, Racca (ye
(Total ¥amber) (Yearly :
4.. Name of. Deceased.. c DE veces VLMMAELA. eerie Feber ee
Born) (what (whe
. . —_ Wife—Witew. ose se dene ‘Gee th phen OEE Aw Aine OMS A: Oe eee Teer ys Charge to Sie We
Se tide 6 coe . . va . (en, aie tae” boule s+ igen
, Order Given by... 0.0 fleece Necccccecceceeeeees dues ;
some] semnnenane GW SOON. coe dypiieles ss Vedbiee 4s acios'e » eeidbiess seeinesie ee Price of Casket ef Dolliiccys fl shai rs aes $
5; : “ Metallic Lining ......0ee eee eee
am ee Date of Funeral.. 4 Sip llh sesleren gy wararetk oo : 4 ic Lining (State kind) . iia
Residence . 4 MAN Eine o altruars xi waits Ciaicle Bam 9s ese3s a cosa sterner: ig
oe en se % © “Grave: Vault cpecices cscens reece eeees
Place of Death...44... ahi c on ginqecage ohespreses eKisiged 56% aye: yaw ps paar ga ree
eps caetinas Funeral Services at.. (4...4.. 8G ins winievoied dosing aos “. Burial Robe. . tegen eens
er Time of Funeral Service.. ....c cece ees eec ce eeeeeeens : Burial Slippers and Hose. giiresezs: a
Roe event : Engraving Plate .....sccsccesssceceeeesees
— Clergyman Embalming Body (with. ....:50/ 005 6.5-Fluid)
. Certifying Physician 4 . Washing and Dressing. ..---.-.eeeeee erect es [een 4
aay (Pie ae His Resid ad g d ff .: a Shaving 20. .ccecesseeensecceseess a isieiae es . eect ‘ :
apie : Keeping Body on Ice...... es ceee cee eeeeees .
“ne! Number of Burial Certifcate, : Disinfecting Roorns .....02 cece eee e eee eeee es jc %
oo Cause of Death......eeeeeee “9 Use of Catafalque and Drapery...... avezevoieis oe cdl eatle oe i
a. “ Folding Chairs ......eseeeeeeeeeeeee mtewersen ene ne mee
Macs one Date of. Death. . “ Candelabrum and Candles.......+.0-pen sic f
eeeeeeseees Date of Birth. ... (Ay? Gloves $....e00c00Crane $.cd:6c ss oeearet ts athe IO :
a . ae Occupation of the Deceasefl. . hh Door Crape $.. ae.» emyore-wies e0 Canopy $. e:8 0 ndese eta 8 6% ATE [pL SAE e
Wo : Bficedenfre ths apeiereye'v oreracdla aald aap eae arcinere ngtepegeery «nerd 2 ‘eo: you — <eaisibanibi : : ons ee be oohon noth
ha Pa Single or Married UA . . Religion Carriages to Cemetery. . @ $. Zz vee tee ewe _32 0.0. :
aL cenene Aged..72.. Years, ++ A 4..Days. . Automobiles to Cemetery... — $i: i canigs spac genes . et ;
ot Date of Birth..... “anata et Leseliee sells prenigies » eee Wagon Deliveries .... seen eeeneees steneeeees save f
sete Peatienion Naime-gt Father”. City Calls (Coaches) 2
= eer ; Death Notices in..... i
am — His Birthplace ..S70¢ vars seve qptevenlpinsrign “soto bodbvoe naga tan tac whieh Ommeonl. CRcEeCg
Ae Name of Mothet.ssevsssssegageese res sift apg ec iinon eee Her Birthplace.... if Outlay for. Lot..... eer eee ia ceitsele aniecoSiar’ foal,
me, Mother’s Maiden Name . Opening Grave or Vault.... pe eeeeee seeeeeeee an
an) aN so Shy aes Lining Grave cs. siedais ssssiceis os s0sie'l cunste ong ;
BEAT. We PERRGPA thes 05.2 peninnss indorendy soarmeyes baleen Vault Re URAL 65 fs ans loensina ven ebipa co ee my oe
2 Size and Style of Casket or Coffin..... Pileowpeacegioas Shipping Charges, prepaid. ..i....is00 ete.
seeseeececen, eeevede Peewee eeerwerene Cee ercccercvrcscc es ecereeecces ° Remoyal Charges elie ade a BHA ale lie i a ene
a : tow = . Cremation Charges ....+0seeeeeeeeseeeeeeeees a baton
r Manufactured bY .:+.00+screveeceseeeereeevere sete reer's "Porters occ eel ecl elec blac ebee eds eaccecgua'ees'. [ummnnctih] euae
Interment at...\ 7d eet \ ustwerw mela Cemetery. . Watchers 0.6. cece cece cc decd ee de dec gee tele e ye'e'e’ [funded
. Lot or Grave No..+0...3.Section No... Vidsidiers a ated Personal Services.. ++++s+eeseeereensevares ot . e
si ang . Music
_ + 1. Church Charges .
: 3. Ce ee ee
; _ . 4. ee
8 ? 3. ;
Zr . } ‘ . S. : Total Footing of Bill....:. ee ekeer saucy SIL
a ; Diserem ef LotorVanis: By Amount Paid in Advance......2ee0005 ao
Designate all Graves in Lot with Wonton (1, 2, 8, 4, ete. ye and i fy 8 ‘ :
‘ r mark ess for this Funeral with a cross (+). Balance.,.... % ob flattaw a geg oo aie . hs
‘ ate place for Monument with a small square (p). : :
‘eset b in att Span to Tie Right of Diagram fpr the Tames those ber ted Entered into Ledger, page.:......0r below,
the wile ;
———_ 7
LACS
1, fo tin To Funeral Charges.. .: : Total, $ Pe 4 AL. Mise . PBy Cash: :..:2... ween dG
<ecemmons mE Bll tensed sis aaisessomean sri tieobopccepseety. oninSadsnnelll bag I eoeeeenensencerel ft censene . exeneedhSneeSarclnenienileseerasenlieniee:npdnenencorestiion I] cqomnestsbe tie tats ~ iF
ccemgaie Gesstccn, . scccopsouis Sestsensseeedecsasnsentees © seisessneee-sstectesbeeseneseminne [I oncheongee: sagbonveaten: i
TS, a See, lene ; ssp saint ce a