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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
"Manufactured by je.sseeseseteeeeeeeseteseeeeeeesenes
‘a2 Interment at..<5Z
sei (Total Number) :
Name of Deceased. 7
i Coes yy BPs d. neh a Dist
Say Lh. &: coy d . .
waecwamoy Week: a i eae Charge oY yal eld lee een se ebay ste Pes
, “i Date. .°447.
(Where Born)
Address . _Ze f
How Secured ..ccccccccscccccvascesceseccevesesseeees
Date of Funeral.. , SG,
Me ~ Residence seed ma SIO, sisle ioteves Coie oss
‘
Place of Death. icctocce poctgs oete le iahapeag te eee 03
Funeral Services at 7
Time of Funeral Service.. OM teh
Clergyman flr OP OTE piasisiae-arsince:
*. Certifying Physician WP. ‘6 SU
“His Residence’ 0c. hii cece ce ieee ee bea ened eee e neces
“. Number of Burial Certificate....s.sscsseseerenereeeees
“! Catise: of Death .635veeere cide cola eaPu sade! Vesti Ie
Date of Death;., WU Mee B.A LGL, ‘pea
i as
Date of Birth.... Aol Loewe m4 tea’ din-t'e'e
Occupation of the Deceased.. eee
Single or Married.....++++GOR
Aged.. 9.0.55. Years.. Zoc0c00 Months,.....-.Days.
Date of Birth. ..eeeerseeggeeneaghteterygeecse ster eset
‘Name of rather. 2% ff : APS,
His Birthplace
eee ewereewereee
wee be dere eweere
Her Birthplace ...
«.Mother’s Maiden Name /
"Body to be shipped to.. .4eseseersepeeeeseeeeeeerereenes
Size and Style of Casket or Coffin,.,...0ss.seebeveseeees
¥
etapa eee eee ewer ereeeg enemas ererersesererveusssHsasegs,
PZ ceeeee Cemetery.
+ Lot or Grave No, ..06++.¢+¢+++Section No. sess .seseeses
Design: is all Lot with Numbers
soekord, for a Graves with a cross te). h.
lace for Monument with a small squa:
Price of Casket or beatin scales ea
AT ease osc aisce es sence ‘
ee erg ees ee ee eee Hee ee ee
% Total Footing a Bill.
By tAcnoant Paid i in Advance.
shina’ «ae 2)
Metallic Lining ....0++ee00:
(State kind)
i! Outside Box .....-++5
(State kind)
* Grave Vault \....-.++-5: Uvea wae ss
ee er
“« — Burial Slippers and Hose....+++++++
Engraving Plate .
Embalming Body (with.....+++¢+++¢:Fluid)
Washing and Dressing....-+++seeeeere verre ll
Keeping Body on Ice...6..-0see0+
Disinfecting Rooms ...++++++seee++
Use of Catafalque and Drapery,....-++++eeee:[H.
“ Folding Chairs .
“~ Candelabrum and Candles.....
Gloves $....+e+e+0++ Crape $,...
Door Crape $...... Canopy $... She decace Heke
Pere eee eee ee ee . eee
eewee
re ee ee ea .
ee . ct
Carriages to Cemetcry....+
Automobiles to Cemetery... @ §... so ebield eg
Wagon Deliveries .....++-+ da 6 y aimaiaTed 6 ae .
City Calls (Coaches). ...ssseceeeeeeee reac ees
Death Notices in., eat . «Newspapers.. 2.. ++. fteeter eleee eee re ee pe eeeee wes
( Names ‘ot Demssanersl
BlOWers 20s yee ec ence ge cess ge enete peg sveen . ,
Outlay for Lot....
" . Opening Grave or Vault....005
Lining Grave ....
Vault Rental i. ccc. sek eee eee
Shipping Charges, prepaid...6.seeseeeeees ers
Removal Charges ....-+++e%se Sieie sidig ayate Alea tees
Cremation Charges ...6.seseseeneeseneeeeetnes
POrters .. sisio ees vga vie'ne ose vie'epe Obes ciele't Vale cep eee
Wotchets. bess sare dreeres gs
Personal Services .s.ssesiegpteeeseee eee ie tects
Music .3,.secece sete sdee een edly
Church Chargess. 2s svsens ;
co ee a eC a
eee Ae eee weeee nes
ee ee ee
re cae .
eee eeee
ee ee ee . Dee
Pe ee ee eee . oe
were eter
we ele alae ee pi tig eee ae ee
a
_ Uses space co fo the right bi Lae ign for the names ceis ot : at
glist To Funeral ea