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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
a RECORD OF FUNERAL. _
we 092 eS are Co eae p Bik ILS 8
; Ake Pe Ceres 4 ‘’ pe Fo, EN
= Name of Deceased. A" my od aS UENO xv.
;
: (Where Born)
eee eee rrr ee eee eee
Pa e _ Address ...++ Died hte cenit Ae Metaxas
Dries Gives by, Fe andes Bendiagd Seep sacar a 5a a
How: sek Ped Pe UPS ds Seo ee Ue ep eee taibed es Price of Casket or Coffin.. .s.seseest eters es$ fla) Me:
; ‘ “Metallic Lining .....+-+ : :
tneral Heats the ag Bates : ; BERETS ‘
Residence Peale Fecal e ea ee _ Outside Box tle Fo ta Neceex ar
Place of eid at secdegd “-) Grave Vault ... ts Z cory i
Funeral . Services’ ates. ae ake Burial, Robe 555.5652. ccsdebdesd bec d eee CAN Lae
Time of Funeral Service. . volt i Slippers and. Hose.. Ba ate aan barre
Cletgyman ..A¢29C + . Embalming Body: (ith ees a) AA Le.
pape sie a “A OM wpooeiviss. ds . Washing, anid. Dressing, .. PR et sess red. Nate acks . eet
a. Shaving’... soceedU abe cabee cSOk gine ee scceko . l Sepia (deere?
hae . cen EER aa ee a Keeping Body'ob tebe ae iksiie teed tenes ed Bae
ber of a, Sur tedecereeenenee*. Disinfecting RoomS'.,...eseeteeteeseee sense . ease’
% Deaths FL Cae og adapt BO Ce ce cei snes cise . Use of Catafalque and Drapery. i.. .2. er Wine aici ears Accu bel preatsee,
Pe (Primary) [Secondary] ~ ‘© Folding Chairs ....0..+ PORES as iss eS :
pate, of Death..» ia: TALS ae Sisncss . "OF Cigdababitlati wad Candlen totic sett es eee WS
aterof Birth. ci .2. 4 BOGS: Sa isc 2: Gloves $2.2:ci3ssis0ids Crape $2. ssees ce Les
‘Octupation of the ae Lenny, i pbateimnpadis Door Crape $...+++ vee. Canopy $.. +100 see. voons ntigesee . merge
“Singt Mi DW bh ff Rell “ry -pes. Hearse .... csc eseceeee GEN Chases a 2ha epsev aaa LL
ingle or Marrie eligion, Carriages to Cemetery...1:-@ $isceseeeeets -y . Esreemeey (Nes
‘Aged. ss oes o.. Years,... weoees Months,...0005 Days. . Automobiles to Cemetery...@ $...veages hoot Len.
Date of Birth. ..... cc cece gece eee gee eee eee etenee eee Wagon Deliveries ... ees eieceeeseneeeten sees sssee meineenn . earned
: City Calls (Coaches).. ..cce eee eeetee ee eeeeae ‘ansible cet . segensns
Naine' ot Father. af. a. 45: 7 a ia * . Death Notices in. .... Newspapers. ooo. 0 oe + [fee nesee ,] pacaaccoee
-His Birthplace ... Yolea. PERSE Ns adbeaee wae we wereawegesbdieeaees ae dviette iti . bea
Naine of Mother...-. Flowers ... te : a sin wet te Wats eels d).e2. 32.
Her Birthplace . Outlay for Lot... sis RGR e F Syatwleedts Aer ri . acannon
‘Mothet’s Maiden Nam Opening Grave or Vault......0065 Aer mu mnle\ GY. .
. Lining Grave ....eeeeee ees denis edhe FLT Ba Stes ANSEL.
Body to be shipped to FEET STEERER TE chee Reece ewok eee Vault Rental ..ccccccecccccsebeccececevceees ee
Size and Style of Casket or Coffin..... araebie Sie Ss:diwee-e Shipping Charges, prepaid... coke tales dartceie’ ei
Bodies he sd ss Ri isadhewge peas slp amet wesddsinoeee el embers Removal Charges ..+.sse+sseereeereeeeesaces fh
Cremation Charges .....seeeeeeeeseeeeoeeees ee Mee
e Manufactured by ....,. +. Potters esiccsei sds bee de sec cees Soba degus bed
_ Interment at. the » . Watchers ....eeeeees Soeadd d hasbeen anaes notes eiewrsdbnce
“Lot or Grave No.....0-0005 Section No.....e8ee08 Personal Services ..+.++senseesee sees ee see ceeee nents . ane
Music ... 2c ce eeee cece econ eee ee Pee ee . et
LD Church Charges .,.. ais sg's so osiesite ne Waynes ofl tious .
2. sheeeene Perey & e.-* 2e > >, Se é qT:
3. eee eee meee eee eee e eee eseese ee fsoseveeseeeeeeeeeeeee ics eee
4. fads h aes Lael’ CUistles vole iB iinabe hyn zhais i oe i ee ee
aan ke =: Total Footing of Bill..... bis ekedes since $ Lap Cae
Diagram of Lot or Vanit, By Amount Paid in Advance.... “aswiat bates Sol aces OSS :
Designate all Graves in Lot with Numbers (1, 2, 8, 4, ete.), and
matk space for this Funeral with a cross (+). Balance. .cces ces cscstusecescccuc’ ara
‘> Designate pane for Monument with s wall square ( : i
vee space to the right of Diagram for the names of buried Entered into Ledger, page......5.0F below. . . snwsnoo-. . a” 1:
LEZ A " Li Lhe ! {
Lam é 7 * 4
To Funeral Charges.. .. VAL 1, 221 By:Cash.....06 boekes sis $. . _/@AZ
Solis PNR SERCe shame (eon WO &