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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
' Ses gee
Ui serly Mapve (Total Number)
Name of Deciaial:
“ .Wite—Widow 1,
Son-Daughter of
Ee Mop
ed Dcd o Ode CRUE cade SoU pee UNCP OCR pes VE coe ee, Charge to 2 593%.
sai Bace)
Address .
a Maoh Tees
Kk
, (Where Born)weet eee
eee
How Socithed. Mei eek Niet ge tceb ors
Date of Funeral. 4 CAA.. es
Residence .. Ming
Place of Death.. £4
Funeral Services at.
Time of Funeral Service. Las @' <<
Seine laa eA.. Ae Seg
His Residence.. ¢ 4 “Hs 5
Number of Burial, AOR pA es ella ic
Cause of Dente vebteveha pets veghis sre iaaernaices
-peiiie pani ian TET: pec me
Date of Birth. ad KP. Sy.
Occupation of -the Deseloed: A e,
Single or Married. Mi Lae : Relision he A
Aged ae Vedra, iv Bases Moatlie ical? deve.
Date of Birth.. 5 s.-+++22, ‘ico emiee cin on
Name of FathercZem Li £:
~~. His Birthplace.. . YEA AR ES cece eee epee deere t
iE Narne:ef Mathers AGT Tb oivivedl. eoasanroeenes
der Guithplncen te ee Tralee Bibs wk EE hee eral
Mother's Maiden Name /oshantoet, C4 Sa
Body: ti. 6 shiptied tomys'sids «no vlhisat oi We antnnaines
“Size and Style of Casket or Coffin, .. 06.. eseeeeesneee eee
*» Lot-or Grave Hemicaininiie NOT ce ienee Fees
a ve eee ee ed
Terror rt eee eee eee eee eee
¢
reEy cee ee eee) Clergyman. .4
ve ween
Vsmtoctared 8)
Interment at.
Eee aoe Se
PAX ligt Hie NS RTOS
t
4 Magram of Lot or Vault
ate-all Graves in Lot with
ce for this Funeral-with a cross (+); mark § esignate are for Monument with a ait square Bi -o Soe h
Price of Casket or Coffin......-Mos ge$ La
4 Metallic Lining .....e0eee rere é
(State kind)
f Outside Box .... cece pee eee eeres
(fatave kind)
f Gears Vent rset A retate « » a
State kin
«“
Burial Slippers and Hose...-.+-++++*
Engraving Plate .... n't
Embalming Body (with.....Le aeE
Washing and. Dressing. ..
Shaving ...-eeeecerreseeeneeee Fe ets
Keeping Body on Ice....05+++++
Disinfecting Rooms °.
Use of Catafalque and Drapery....
“ Folding Chairs .....+-+++
Candelabrum and Candles..
» Crape $...
Canopy $....Door Crape $...
Hearse ..
Carriages to Cemetery.. 44.
Automobiles to Cemetery.
Wagon Deliveries ...
City Calls (Coaches)....0.+seeeeeee eer gers
Death Notices in.....Newspapcrs..
ee eeee eee ween
se eeeee eeeee
Stee eee we eee eee ewes nee
(Names of Newspapers)
’
Outlay for Lot.....4.055 Siscecsisew + 2:0 Ste Ry ot
Opening Grave or ‘Vault..
@SBEE poe:
Flowers. ’.cisccecesnecgudcsccauevoete Be ees iad
Linkagitnye «de coco. Vases Ney bre Weldiace ieee
Vault Rental occ. ccc cece sees cece ceer eee beee te é
Shipping Charges, prepaid, nid Busey Lee ainty VeROe
Removal Charges ..+-2++sseeneeeerreernece ent
Cremation Charges ...00+.ee-eees ate
POTETS 5's 0 p.0 0.0 be ewes eee singe ceoged meee Ais
. Pekamincg rey nk Seer et ee ee
Personal Services. needy ee tate rere ne
Church Charges amenity
Sia ict oe Wis'b.« G00. ViEAE ecole Sw ER CEBU: © wiele Supies pre'e .
oe ee eee ee eee ee rd
x y Use space the right of Diagram for the names of
eae ee ee
f ft ro. Simeral Charged aii seta LIA gee GF . By Cash is ORE BR EL LS
PHS Pr ed ee er ke ian Ecce] eae EP Coo eAeMige nee age On
Names of Pall Bearers....0.0eeeeeuee ae ee NE ii RE ae ee © wae se De egeedt geen ooh