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Collection: Original Records > Death Records

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

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ae fo viyeiane ‘eee wa No. ISG.. hy a bias cresapdegenesteCeaudit (Total Number) Name of Deceased. (Where Born) arte, Oh, sec clsnena ened é mainte Race) Wife—Widow _ Bon-Daughter of PrOrrrer err errr ree ee ee eee Charge to . Nez eee eee Address ‘Order Given GPa ccciia'snsunas viernes yaitunte sen in 6 Swielere How Secured .... wee Seco eee reser seeearesseeoessaseorescseeeese Price of Casket e Coffin.. Metallic Lining Date of Funeral. « Residence .. cc ccc cee eee eeeeeee $ Outside Box “Grave Vault i a ee “ Funeral Services at.. Time of Funeral Service. . Clergyman Met. ee Burial Robe Burial Slippers and Hose. seeeergeeeeee dl: Engraving Plate weer eer eee e ew eeeeeeerersseree ELLE.. Bidiogewns Embalming Body <(with..:+. 4 igcderredegFluid) Ja ++reee++ Rei + st Certifying Physician. ...!ASA UA.....Je 6 8 slags Washing and Dressing..,.-.+++ Shaving His Residence ..... WS. Ghee sein oMtacetere +5 8 Batwiainnd on Ice....+++++ wSuie's Keeping Body Number of Burial Certificate. seen eeneceeeenees swing « shlowens Cause of Death. .....c cece eee ny cece ee ce crete eseaeees Date of Death.. es Disinfecting Rooms’ ee Use of Catafalque and.Drapery....--+-++++++ Date of Birth bee & odieSlaig Peace9 Rafigion....++-++++++ Yearsy. cicgeve cee Months,....-+ Days. Single or Married. wisleiore « 9 sracorecwig’s s-ncpcereie « 5 SleisTb ES S16 3 4 8 Bisnre Date of Birth... Bie Hearse ..ccccccccecessecegeeeeenceceeereceees Carriages to Cemétery..... Automobiles to Cemetery... @ $. «. wieewnes hes Wagon Deliveries City Calls (Coaches) bp. reyesere: 9 wen wsniie e 9 9 Bivisis 6H . ass cancetye weaed¥s sie ae cicseiee Name of Father: osc osccec sense
His Birthplace .0..¢-cceseccccvevnccedenaseeeneebe Death Notices in...0.. Newspapers....+a sy eT enatasies Name of Mother. .....0+eeeeeeeeeeeees oy gaisicas BIOWELS 1.. Se Te eos wae eo eeisidinrs aeiaered opeees Outlay for Lot. eens eeeteenes eee ee cece ceceeeeee Her Birthplace ....ccc Mother’s Maiden Name......s:eeeeeeeeeeeeeee aia§ Body to be shipped to..... pee Size and Style of Casket or Coffin..¢74% ——~ = oF Candelabrum and Candles......2. 0000s hae WISRIRHe oS sind lhe © srerarerasere esiewenle sel .. eeeees 00 se eeeee deren Occupation. of the Deceased.. Aged.ns A “ Folding Chairs [Secondary] mary) SORE. Yue. Fennou Co xno Opening Grave or Vault Lining Grave errr ee ee ee er Vault Rental 2.0.0.2.. ccc eee eee eee eee ene Shipping. Charges, prepaid....e.eee eevee ees Removal Charges Cremation Charges Wiel Sie phe + oo doeceibia goidbisig d EaRRe POrters © 5s sinsinie os sisieie o's 6 wialeretg se cuseieie no oe 00g wee Manufactured by: sieescee cio ooo eee. Cemetery. Watchers Interment at....+++ ABMS, ection No.3...2526 i Lot or Grave No. ...0606. 4 nee teees cere e een e0ee Personal Services ....-. ee ee ee Music ee ee 2 3. ee 4. ee ee ee eo 6. 6. Total Footing of Bill. .....s..ee eee seves $llies By Amount Paid in Advance er Diagram otLot or Vault. . Designate all Graves in Lot with Numbers a, 2, 8, 4, ete.), and che this Funeral with a cross (+). mark space esignate place for Monument with a small square ( the right of Diagram for the names of t ee buried Use apaes To Funeral Charges... Total, $ 02h Names. of Pall Bearers.. sea 44 q ermine ose wcuracma ane Rin 84 B08 . Balancesis ¢ sssiasis sose¥ess ween webs Entered into Ledger, page.+...+.-. ..or below. . ! _ By Cash, Aeorenactd>..$