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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
Sa
No. £402.. bate tee'et 7 No. ade se eeee 3
(Total’Number)
‘Name of Deceased.
(Wh
esa ate tna wantin gy : Charge to . —1G
. _ Address . tee
Ci tue ts drei & ercictors “el teoecinsiet hut Bouheat!wsdee’ a i
How Secured 20.. cc. eeceee cee caceceeceeeeeecens Seeees Price of £ Casket or Coffin....+.+. eveeeees $ mnpod. 2 ze
Metalli © piesageinis g plgieisie sae aveimiaie,e SO
Date of Funeral. ies » Meee a ar (Stave kind) = sy fs
“ Outside Box .eccc cece cece cece cece cee . nema] ZY, i ey
Residence .. Ai d Uf het a enemies (Btate kind) oe, i
“ G Vault « dasiesss iasmais venice Gis 6 8% rr . eee (Rel _ Py
Place of Death.. Z, rave -Vai PEAT are ‘
Funeral Services ati‘A Burial Robe: .o.cce ss dsescciee owoeee eden sence i
Time of Funeral S “ Burial Slippers and Sow atsieie ¢ 4 WaSIerE S86 lsssonsesieboail teat 4
IO LO Engraving Plate ....0cecececesee ences ee ees . femee se scents ;
Clergyman .. nn ‘ Embalming Body (with.... iS 8 OE bY escemcoielf eit :
Certifying Physician: a fs PME oe bccccees Washing and nici elowoude US wmicde 8 HORE Sans ace sch ees fcinanetn i
His Residence .. bids y tg = are Shaving ....,.0+008: res 1 4 isIE + PUNUIE 8.6 4 806 a haetomee Et
mE meets we F en Keeping Body on Tee.. weeeees mtinn pw wenagun #9 0b beeereneomsif api d m mi
Number of Burial Certificate... de Sewn ePigesedonesin ss Disinfecting Rooms ....s.esccceeeeeeeee eel '
Cause of Death.....5:.505005 § siege MSM ins T8.050IRe & Use of Catafalque and Drapery.....5sse0005 esersspnaseapel ert seen &
+ (Pete [Secondary] “Folding Chairs ..... cece cece eeeeee ees ensommartoc noe! #
ate Of Death eo 3 by. ALA EB asevrcees “ Candelabrum and Candles...0.600000222 + foo amma) omen is
Date of Birth...& hg ahhh. Soe si veeeeeenes Gloves $.....2.0005 Crape $..6...0006% cvomnscensesee . eesnseens :
Occupation of the Deceased...0STTTv vi ivveseeeeaee eens Door Crape $....++00+: Canopy $...+++0055 Looe eeiaeesl sass f
Sing! Married Relic: FLCAY SE sorsinry & sinisinie oo eiSenrees + a:aiszere 6 4 Sigugpsien,¢ © 8:01609 + fh saeemenented Ser \
ingle or Married. . ree STOR ues seeiginiee's suns Carriages to Cemetery. ....@ $ivce cence ee eel cscs nen wa . ccnepee eee ii
Agediosisies ss ee . Years,..+..$.. Months,.. G. . Days. . Automobiles to Cemetery... @ $.llleccceeeee nen ZO.Date of Birth.....ccccceccccece tak Wagon Deliveries .......0% Srracnteyeia & 6 erect sins santoesins hs
a : Reet! City Calls (Coaches),....c.ceeeseeeceeeeeees
ame, Bf rather. Atesdip re Death Notices in..... Newspapers..... Bed sf
His Birthplace .,5<¢ swe ai sbeb bests sas idedbene gels tev too ree :
Name of Mother..,..,. we Flowers . 0.. ccc cece cece eee tee eesnetebees wad
Her Birthplace .:.:./ Outlay for Lot
Mother’s Maiden Name Gnade. rhage pes Mn! Opening Grave or Vault.... iatohas Ba waISLS 6 BRN
Bod hipped y Lining Grave «0.0.2.6. .eeee esse eee saeiee bps eee
y to be shipped to.... OAS Be cress 2 beneleltve 4 emma eg ef Vault Rental .... dec te eee eeeeteeeeaeeees
Size and Style of Casket or Coffin. ......cecececeeeees Shipping Charges, prepaid: .:..0.....0085
Si@iSleigieuelaio B 6 baaLRG B SiSloudie Os wlarevern « sreriece o aoarguee F aid einigces ¢ Removal Charges .....0ss0sseeeeeeeeeeners
Manufactured iy’ & previes . mouSbtadee nse’ eenrdl re decease mene aa SHREEL c crneyy rn ivy streak a eegges
: i OPPETS: ais 6 + catwiesge sarees 6 6.5 winnie 6 eSelete ss wagies . ],
Interment at. a, ¢ am Uierecog Cemetery. Watchers ...:. eclayed «ren ht oe oe ered,
Lot or Grave No.. s. 2. sid a ba Section No.. .....-. Personal. Services. . Poses cereege ewesyvane
shiatiniaing Fc ERS, Bipaebe casi} saceds vveeeod sv nba sd cog ghee teettts ve
oe Church Charen ss coves ssewasis abouts ba wave rae
Be . tt a rience id ae
i 4:. catvssmssnsicscrencenssencnstcrrenstcosenssnesnantnnnnseaananennssrienennnens . € 9 Cee EEO EE ES ORE MEE eee een eseeeerereesereuean
5.
c. 6 ;
“ \ Total Footing of Bill......... 000000 $]\...6
Diagram of Lofton Vaalhe. 5.. , ; By Amount Paid in Advance.. .....eeee 4
Designate all Graves in Lot oni} Numbers (1, 2, 8, 4, ete. ), and : F Me ons fie
mark space for this Funeral with a cross (4): Balance.. 4.6: Mad Sue giadigdcth eee 9 Tegsnes
esignate place for Monument with a small equa: 6 (p. ; : : : sas
shat — APRESS tg gh oe Ee coe Sines mes oft eae Paried Entered into Ledger, page........0r below. . !.
s
be. rd re =
TL 7
ERY.. To Funeral Charges. .:..Total, $ 2, 52%. of eed it By Cash 3s Uisiew ss aakdacied $
Ln fle iscetrci~lreoea aleonage iach Lenten inlaid ree; (en ae (neem ae
Names of Pat) Rearere