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Collection: Original Records > Death Records

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

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W/89 =~ = RECORD OF FUNERAL. No. ini 7 canan Date. Y Name of, Deccased. Wife Widow Desens Moccceeeetecwesedeneseggeciescedees Charge to Latect ae isnt Danie of fi. MAA MRE TES Fees 0 etree ee eee eee ee ee , Address : Order Given by Lik. pbs, Wi dwrareserdd 8 BORE How Secured .... cece cece cece eee eens eteeeeseeeeeeee Price of Casket or Coffin , Date of Funeral W7 ? mi As. WA LF a Wee Tie (State kind) S02 Residence Aha less Pe ree Outside Box ... ‘heme — “« —G Vatllt s.ccecsccccceccsees siash 5 ce sasisoebsws. ebenssens Place of Death. < act. Ya oct cg? Sy Prey i aye VS pinch ina Funeral Services ae. : Hon hen, # Burial Robe .....++: Fob. -aiewcaie'e gts snasaptban tine of Funer “ ; Burial Slippers and Hose.....+++++ eee) ene Engraving Plate ....ah 8 sale winie oberelere a # eroere ——— — Clergyman Embalming Body (with....sscssceesees Fluid) . . —-». @2 Certifying Physici aL) Yr SMe Ge. Washing and Dressing....Sab oRiecesauer :01%08 Pods cuomenn 7 en P etli’ Residesice ” peli ed oe eee ‘ on blaine to Sdaieib be bleesae ewewee sesteneosergeias sestsosoos eeping Y Of Tet.. cc cece cece teen ee ee ee eee : ‘Number of Burial Certificate Cie saaaie od eapeds MY aadw' meen Disinfecting Rooms ....sseseeeeeeeees an Catise of Death.. .. cc. cece e eeepc eee en eee ee ence eee ees Use of Catafalque and Drapery.....++-s++e+> eee (en rimasy) [Sesondary] “ Folding Chaits .....seeeeeeee ee eeeeeeey seca pes [ncadenen ate of Death.... pat Cate Biba bo8 6 ode bi “ Candelabrum and Candles......+020+as 50 Date of Birth. BEDE. hs peiccconckiviagiccviensvel Gloves $....4ee. Crape $... 2 Sia 6 38 enwnerren hes OO. Occupation of the mecpased: Jy ca a PE is isiag a rac Crape $..++-.s000+ Canopy $.--s0+++++55 eel ae ana on Goat hotes Cr e:t0nid 6 RAGS J eayaTS 6 o'sisne Single or Married.. ed Religion .Aeaeee * . Carriages to Cemetery.. s2..@ $.0.5. a a0 6:06;070 ff oun AL \ GS. Aged.. "h: Years,.. va ees Monti .scaeeeesDays. . Automobiles to Cemetery... ‘3 Bi oisseie: 0 « Haigsidte . Date of Birth.. ccc.. cece ccc ee nee edyqeapageeeesecees Wagon Deliveries ....sseeseeeeeeeeeereneees Name of Father. wetted: tA de. bc ae City Calls (Coaches) Sse bee beetine eeewwees bos oe Death Notices in.... .. Newspapers His Birthplace ... SLMIA vce cnn eee ee eeeeee . uie ceeees stdbasdilestene we Benes omgenens -theeea ave iste smecnenereaif inno Name of Mother. C....cgeccseceyecees Sarge Paine bid & ORO Flowers ..< — * eae canoe ewdiaigere e 0 Weasascesnets . oct cc Her Birthplace .. <<¢Gliactt-7... erage ended 4 FMGELE 8 50 Outlay for Lot.....+++ die bs bararaces aikintele «+ ae Lat epi nics, Mother’s Maiden Name / / Mb lant. : at Opening Grave or Vault.....c cece ecceeeees Lal a2. Lining Grave .. cee be ecec ese e enon eee ee ee eee ens d. Vault Rental .... 0. cece cece eee eee eee eee fi. mowtileoseaagese: . Shipping Charges, prepaid.....eeeeeeeeees easeaneen> Removal Charges ...ceseeseeeeeeee eee eeeene seca naacs Cremation Charges ......seeeeeeeeees o's sexe cian cass 7g QuarlalddlicE Porters cee cece cece ccc c cee cece eects eee cee ees eeepiin ett amenities Interment at. AT. Died 3 4 Baier Cemetery. . Watchers .....ccceeeee ee eee eer eces essences vevseemnneeenee . seennsonee Lot or Grave No.....0-005% Section No....eeeeeee Personal Services .... te ees . code : Music ....eegeeeg sg cece nese gacccesceeeeees . Church Charges Iles ‘Mise sie 8 sipsaiare § 0 avete nm 1 oo 4. Moen ceca de li on peagitlubnccech golden tot Po 6. Steines . Geet eeeteeeeees [ = Total Footing of Bill.....ccee cece es ee eee $ Lee\F2 Disgram of Lot or Vault. By Amount Paid in Advance... as patecsree epitidiens en Designate all Graves in Lot with Numbers (1, 2, 8, 4, ete.), and mark space for this Funeral with a cross (+). j Balance. ...cccccccccecsccccees Paes uae Designate place for Monument with a small square (£9). in ee mane the right of Diagram for the names of those buried) Fitered into Ledger, page........0r below. . . . . . : LG/$ a ! ‘ ; ¥ 77 ‘ ara _.¢\To Funeral Charges... Total,$ . _7.2 G\£2. ry ’ —_