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Collection: Original Records > Death Records

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

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4 Fh ye , nA vd f and ; & 6 2 is . ao. 10 ge eng K al ee . ‘RECORD OF FUNER ‘No. ; 7-2 wishin ge0 (Total Number) Name of Deceased. No AB. 38. ee ery ry Wite—Widow Son-Daughter of Order Given by. Mb. Corts. Slike. How Secured ....f§... Date of Funeral.. Residence a) Funeral Services at.. er an Time of Funeral Service. lh heeft + dlaggieade* Clergyman ..... [tex Dad, IPAs.. Certifying Physician ...: Orroned. evan, Meat, His Residence ? ee ee ey Number of Burial Certificate...0... pees eeceeeeeceee — Cause of Death See ee wee wen wee serene Date of Death.. ; “ Candelabrum and Candles........0++]f. Date of Birth.. C400.. ccc cece ence esc cececeeteeeeees Gloves $......085 Crape $..... eens Occupation of the Deceased 3<-..., . Door Crape $...... Canopy $..c.e eee eee oo cccnee . Sing! M 4 LO, . a li . Le». , Jeane Hearne. isos axeea.s oagihie eps aldiewion 2 care sinas« sewers § ingle or Married.. A407, eligion. Carriages fo Cemetery.. LX & @$ Cee, es call, Aged, 9 . Years,.. 2+.. Months,. .2A..Days. . Automobiles to Cemetery ae .@ $0.5.5040. ‘ a Wagon Deliveries .....6-s0eeeeeeeeeeeeees City-Calls (Coaches) Nanié: OF Pathetic. < cccows sietiows + a swears 6a maid 6 4 amine ss Death Notices in.. . =. } His Birthplace ‘00. sescaes vswses oa siestssswinewisths samen’ . . cca evacceedwnwaseec wees aceon dhtiean a; I tess exes veuy [fnmecommre (Names of Newspapers) Name of Mother......:ccccsceeccscscceaeeuceaeeucs FIOWETS doc occeccecccccccccuucccuccncvcutebes
Her Birthplace 00.0.0.. cece cece eset ee ceteeeeeeeeeecees Outlay: fr Loti « «saa cys tigues s easacd eas tees Mother’s Maiden Name......ecceceeceucesevcevcucs Opening Grave or Vault......++sseeeee, meg eM Lining Grave .....cccee eee e secre rete een eeee Body to be shipped Co t+ . Vault Rental oo. .ccccccccccccccccccccccccecece Size and Style of Casket or Coffin.......0ccececeeeee Shipping Charges, prepaid....... 0.00 ee eee ae TRPRO Radio oe ngnpg oe enna e oeeelee ee HUN ee Melee o vesseees . Removal Charges .......0eseeeeeeeeereees Cremation ‘Charges: opcirec s cswsw ss eases os vases Manufactured by ..yoy, srressereeeees ranges spe Porters ..eeceeeceecsecececcceueeees ae me Interment at.... LAG. eee Cemetery. . Watchers ......0.secceeceeeeees gas She ‘ets Pees Lot or Grave No ee eeses ee ee Akal seeee Address “gy wie Pe es Charge to Lhd. Canrtf. , btn. Sak i Cheaeo,.0 a, eect we ees ' t Price of Casket or Coffin s Metallic Lining ee ee “t Outside Box ee ee ry *(Btate kind) Grave Vault .....0 cc cece eee ee eee (State kind) Burial Robe “ ee ee a Burial Slippers and Hose.......Bagravind Plate, oss sa vciewes Premise « saa ee oes Embalming Body (with...... Cameras 3 Fluid) Washing and Dressing.......0ceeeeeeeeee Shaving ....... Aigies ¥ 4 ew igiig 4 Caeerew Ve mete Keeping Body on Ice......ccceeeeeeeeeeees Disinfecting Rooms ......0cseeeeeeeeeeeee Use of Catafalque and Drapery......0.000% “ Folding Chairs Personal Services: oi5:0j0. 2 vs-ccia's ossersie vedagiaddas Music ee ie a re ar as 1. Church Charged je oiiesc esis Yfas evagige oyedees 3 es a oer a7. ee i ee ee en Jed Pe é re.. 4. neointima . ont asvabie te gnnver tenes asesinaeey vanes + 00g + Hem manus eS Total Footing of Bill.. .... ccc cece eee eee $]). Diagram of Lotor Vault. By Amount Paid in Advance.......0ee008 Designate all Graves in Lot with Numbers (1, 2, 8, 4, etc.), and mark space Stor this Funeral with a cross (+). Balance... 2.2.. cece Dees eee ee eee esignate aye for Monument bef] a spell equate (&). Lot uae space to the right of Diagram for the names of those buried Entered into Ledger, page or ‘below. . ! ...... eaten naeceseee To Funeral Charges... Total, $ . le Pon . By Cash.. .... eee eae $ t