Enter a name, company, place or keywords to search across this item. Then click "Search" (or hit Enter).
Collection: Original Records > Death Records
Mortuary Records 1914 to 1919 - Book 13 & 14 (310 pages)
Go to the Archive Home
Go to Thumbnail View of this Item
Go to Single Page View of this Item
Download the Page Image
Copy the Page Text to the Clipboard
Don't highlight the search terms on the Image
Show the Page Image
Show the Image Page Text
Reset View and Center Image
Zoom Out
Zoom In
Rotate Left
Rotate Right
Toggle Full Page View
Flip Image Horizontally
More Information About this Image
Get a Citation for Page or Image - Copy to the Clipboard
Go to the Previous Page (or Left Arrow key)
Go to the Next Page (or Right Arrow key)
Page: of 310
. RECORD OF FUNERAL.
xo.. LAG 5 deitine No.. expres BN ae Date. . P<) Ep eee 1942
(Total Number) (Yearly Numbe ;
Name of Donen Melitta tate a ge AeA vv CULE Ma soesssesgecece ache. eles
. (What Race) (Wheré Born)
Wike—WidoW ence cnn ee ence eee cnen er enecones sta t¥aees Charge to ...seseeerneeneeeeeees pops ccesess od wuuvee
Son-Daughter of ial *F
' Address (420207. ..0++: Wht miaevainis sja(eress weinieey ce
‘sOrder Given ry. Dtae. RA caa'sadbidels donatedteeeet ‘ ; =
How Secured. 0.2.0.. 2. cece cece cep ener ee eeeeee Fneaisaivsa Price of ree ee pede g giaieinls Seis eure o $ ommend tanh: (i
ic Lining (6.0.. eee e eee reece lle Fee en
Date of Funeral.. ( Ly Lf Me conde raheeesd ves © " ad ‘(Stave kind) -; ris Outside Box .2.0-.s++-++ sacieins oueaee alnsaitinpsan neal
Residence ....eceefeveeessencce Bl an odins SERVING & #88 . a (Btatekind!
\ Place of Death. ...2.. ce ee gece ge egecterceeegcet stents eS: Grave Vault ih Ooo eee . eel ae
Funeral. Services tiSee€ Ax Lae ewieee'e ' Burial Robe .... ete wee eeecen ones
A “ i lippers and Hose...-.++++++* cexamsipnevcion . eqs
\ Time of Funeral Service.. . fae, Cord Seis PeR eet © . Burial Slippers and Hose. sine 8
A) Lo Z Engraving Plate ....webbed ete eee eee eee seme mmm ——
‘Clergyman a Sfree FA Aa oe ee eee Embalming Body (with....++.++++++++-Bluid)
Certifying Physician Abia. re a eet CEPT eT OTC Washing and Dressing. ..-.++++++e+2rretre' vaca Msc ineewach Someta
ii H Shaving ..csccce ese se eee teeeeeeenceeeeeeeees en
“Tis Residence ..... ns OP © eee : i
ee Cu yoy Keeping Body oti Ice ::.5.c.c0bcedieseneese on rae ears
ber of Burial Certificate.. /...-2--eece en esee obskse . Distntectitigg Rovedie-1.i52.Cii8is ave osaece ote . ne :
iise of Death... fey Bt PE SR LS oti oo oot be 2 Use of Catafalque and Drapery. ..2eseeceeee ees flee ene pastas
(Primary) [Secondary] “ Folding Chairs .....sseeeeeeteceeners eubcralae é
ate of Death...Cen Abbete.. eee sccese “~~ Caridelabrum atid’ Candles: :.ccieidiscecoe sfc AVE
Date of Birth... Ye Ane tf a. LE. &: v0 a bbes ada Gloves $..... wee eee Crape $...-. eee sees Lisseapinsinads . asecltsis
Occupation of the Deceased. .ZASSE UA. 0. ereeye rss: Door Crape $..--+++++++ Canopy $.-.-+++++++++{/— pg . mr
re estes : rar VAL. AIC. . Hearse ...seeeeeeeeeeey vielen ae oeeige pour: Li £02
ingie’or Marnie Sang. ++ RIN }Garriages to Cemetery 9.. -@ ¢.6. ee cho ie a2
Aged... BS. Vears,.4d... Months,.. Z..Days. . Automobiles to Cemetery... @ $.. 00+ pila lack
Date of Birth. 0.02.. ccc cee ne eee eee eee nte ones a bi ge pr ieetl nontiecst oo OG Sits FE ‘san OM
an ; ity Calls (Coaches). ..+ssseesereeeerecreress saeveeeennes on ne Sora
Name of Father. a f 4, ;* Gi i. a chides semen Samii Death Notices in....+-+ Newspapers...-.-3 ee rT iets
His Birthplace ... ACCA osccsecscssteressees [sacs seseessssuenstnn san ice seseesurgecssassersssnate qj Cem: ee
Name of Mother. ... 0.065 + cayeeee dee cece cece ence neees Flowers ..-raat i” _ aoeea ” errr . 6 ke. . e.
Her Birthplace ....---,+COE a dece eneaGein 9 008 Outlay for Lot....ceee seen ee eetee eee eeneee sssaoee tl acta
Mother’s ‘Maiden ‘Name Ahelee bale eee Opening Grave or Vatilt. : 000 vecceeees aed aes wn . OO
. Lining Grave ...00cceeseeeenseee eee eee see eees t:.\ OD
Body to be shipped to. . 25.. s set pee ence eter eee ee erences Staats Wessttal << calkqacibsa well Setiwee shah seem c
Size and Style of Casket or Coffin. ....+sseeeeereeeeees Shipping Charges, Prepaid.. ce cee eeeeeeeeeeee eriarad, nena
sidiew oo Vibro oo fred dca Severe & capes dd. we cereeins emanne Fo Sis eE9 Removal Charges ..-+++eesseeeeesree cess ces ses [memes [ammeane
ion Charges ...eeseeeeercersonceee eee o [Ec eenanes cove . soesnseee
Manufactured by Ponte cis tess cihestesdengideain téenedton
Interment at. (Mdawle Mh . . Watchers ....2. eee eae e eet eee nee ee eee [emai . sam
Lot or Grave No.....05005 Section No Personal Services ....eceee cece eee eee eee Ul meanness
202
Wael Pooling. of Bill; .,i.c+,+-+-.asasiges aed $9 2. 02_
Diagram of Lot or Vault.
By Amount Paid in Advance....anaes s eoede Sen ene
Designate all Graves in Lot with Numbers (1, 2, 3, 4, ete.), and] 4 a ;
mark space for this Funeral with a cross (+).
Balance. ... cece cece ccecserces naan
Designate pince for Monument _—_ a epall sours (f).
in ue space to the right of Diagram for the names of t ose buried. rAtered into Ledger, page.....--+-.or below. . ---.
Lb tie.
me
' rend
ay a
ray ile
Qeas. 26. ‘To Funeral Charged ... Total,$ . _. 52. Lip, ea By. Cash osc 02 oscesiee’s v0 2 $ Wo ed VAL
Li Rene ieee tn ones, iy seine ant taal An
a/\ 52.
(
16
Tee ee
Sag ee