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Collection: Original Records > Death Records

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

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Name of , Deceased. . “Number of Burial Certificate. ... eeenit gH Name of Mother... » Intermient at. / 4 ‘Lot or Grave Now. .veisas tee (Total Number) ly Nu ber) ‘ Wite—Widow Perr rt tert eee ee ee eee kl ‘ ‘Bon-Daughter of * ‘Orde Gived ty: tadary Sok A Rents ah eae: Perrriere tit Re kk AM i einele'g-are else «6 sadese Residence . Place of Death. .: Funeral: Services at.. .i6ee ese eee eenee weeeee meee eee ee eee ee ee Here eene Time of Fimeral Service. . wiveegededesedtepeeecrtetrerees & M4 Certifying Phiyaheiaal wins (Lee See ew eee ee His Residence ‘s/s Deo eee e ee geeene ts Cause of. Tenth dd isis stisiel deslet yal SoM Nu babons ls « (Primary) Seco : hygey Pr (Dh vi LIAM ca cviss Date of Birthss. cs Occupation of the: Deceased. Single or Married Aged.. 4. &.,,., Years Date of Birth. ++ Name of Father.. His Birthplace’. .4.. L. . sna. Months,.. 4--Days., Sve we vee eevee + Her Birthplace’... Mother's Maiden Name. "Body to be shipped . finial ge a dee Von eons Roig dea et "Size and Style of Casket or Collin beahs Pion goes vedydbyierecenstevddysevnteeddessseedeged HBA teyees eee sere rnte, i) Washing. and. Dressing...-.+2 +++ Gate yy iy PHearse ... gedit shige ,. Religion \Earriages to Cemetery.. . :. Death’ Notices in.,...-eee tee ete we rer ae ly fy See eee eee dee lee wee. Charge to.4 LU. 40M.. Address Pee dS Sie erode H 0 FS ew oe es 0 068. bee +O ame Hee Se Price Of Casket or Coffin 26 eT Ss or aah s Metallic Lining .....; Riven ogaisibie ed ‘ (State kind) 4 “t Outside Boxe....--» aislececorgyeiees “(tate kind) ne “Grave Vault ..-+:.s1:05: Sasbcrraseees (tate kind) «Burial. Robe...5--.:Hs Burial Slippers and Hose. . seete gerne sein eae eee ens te
‘. Embalming Body (with.:...:6 iseie-d apres Shaving ...-eseeessees Keeping Body on Ice... Disinfecting Roorhs NEL cess bob . anata coe shecw's De Cattle ithe serra “ Folding Chairs ...--eeeeeee ee eereresets Come eer eveseosiavies se oe Serer ee eee » Candelabrim and Candles: HK Gloves $. ORR Snes rts Door Cfape 28 be eee eee nee eene Automobiles: to Cemetery. eo . ; N jroiterepies Wagon Deliveries ,..-. fence sevedip oe cists Sees City Calls (Conababyats c sveon sey seer eeasees au aORY Sexe E EB Newspapers. be ‘ikemes ‘of Rewspapers) . Blowers) sees. eee eee eee eee a ole gees Outlay. for Lot.. .. eee eee ee eee pe neta rs Opening Grave or. Vault..+-sssserree serge: seeeee [etag’ Grave vs ssaevoneseetecetensteie et Weeks ‘Vault Rental ..c.e cece eee eee eee ee ee ee rete Shipping Charges, prepaid.. Removal Charges ...+.+eenseenennenneneneenert Cremation Charges «...++re+reeterserue ee eres Porters esis icant aac ba Selene enerwrwraer §diecedd, erdsetOloltters'a.herety vee eee tenes Music «2s -++++ Church Cabra ae sh, fey Designate all Graven tw Lot) space for this Funeral. with a cross (+). : esignate ane for Monument with a small squa si “Use space to the right of Diagram! for the names meact t ‘with Numbers a, 2,8, 4 ote) ing) buried] 5 By Amount Paid j in fa avarice A Lay a 2,3) alt _ Balance iN Ni “ 2 ~ To Faneral Charge, ai. /Total, $ sa j pe bane as, 5 . ee ca De DF a . CL asteedaalaa ean etewentib teergmchsicdand es penne ee pre ay PRUre sto AEN sine aasihe i : % ener eeneanene sr ene eeennees: ee sepeeeeee: ~ ; ? = sccesaeac Lamiaaaal Riesuois satin] MRSS PRAT PRSURag Matic tel POON vom anion aa MB Rune sie PES saeteaneees sprcen aeannne eine ‘Since’ . sacetsoas. . Sstatidientetts eteepees «coamad atusnenee . eosseae . seneenenns: eomigeatenne enanen tesninen arteries snesefenwam sone Arevsoeace: [esest spumenapet: . emeteanen fh saccne! sovenionme ROA SS a RS a les, capherianed