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Collection: Original Records > Death Records
Mortuary Records 1917 to 1920 - Book 15 & 16 (308 pages)

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Page: of 308

Ne
d
Ree OF FUNERAL.
Ue a aGR chives hte NOs cs io cPeccecngteee
Date.. er eethes oie Scweinemeon 19/.7(Total Number)
‘Yearly Boorse
Plame of le easis, ied gcc FE EACH 0 besides no cceysone cas enneeenss ee Cee La cVrarenee Cates
(WhetRace) .
(Where Born)
Wile -Widow UU ges Lobe cleewes 6 oedwe Gia orale ions 'e-alareceiae's vceeccceeeOrder
Given by.----------ercccecerrr
etree ssee errs
Charge to .Gr5-. DE ec eebaee cieceentneceecsenitee Price of Cupket or Collie sh ss capahuxsen ds tas $\. _.72a 12.2.
dress soe VES ee cee cect te eeet ee eeencceesces “ Metallic Lining ..----+-seeeree sere tf Erik Bid parents
kind)
pug pecured Res PAT ab cw ast wo cece cube viecihendensiss wre Outside BOX ss ilee> sees SSRs an BNEO...
Date of Funeral. ‘ aeglaae . (4. !. 7 ee ee
“ Grave Vault .. i5 om es heed [eben Be
‘
(State kind)
’
; ay ty if p # t eh eee eset Litton beers WEY pusdst Pole cicilee « eeaimebe sess:
lace’ of Death... ei Gages Se Sue bal abe seas teke SLs « Burial Slippers and Hose...++-+++++. ~
\g
tihetal Services at. ‘Ponrbat aU ee Alaa tee aines at Engraving Plate :..:.+.sseseeereesererssees
’
Time of Funeral Service. . ey WAV ave toes 3 Embalming Body (with. <.++++++++++++* Fluid)
Washing and Dressing..-..++++ssrerese
rete in mmr ‘
lergyman .. Aa Bab. bIeTd aie eialote leis sieie es EMAL SeaGinar sia usd (Vi Nebatp tes canner tans ces + arb Bieta 3
_ Certifying Physician . “rae pe Sa Pare ced cic Keeping Body on Ice
.
“His Residence .. ID Coit vee tveesisnceveass ieee sae Disinfecting Rooms
I.
: ‘Use of Catafalque and Drapery
i
Number of Burial Gertificate..-+-s+essresereccerrrers
Folding Chaite ...s.sssescceeessueneee
Cause of Deat!
cleerebrel.] bs sage £ Candelabrum atid Candles s:cgoibsess «eat fee
Coctomiiaes? Gloves $ Crape $
eee Genes 1. ete a ee eli pe
Date of Death co Pham SANG. Fares Door Crape $...+.++++Canopy $.:
Occupation of tha Deceased.. -a a na Plenrael cn Coss hesad Sa baesas st one gee eee seme loy
Single or Married Seer sv" .Religion . A Vrs Sik eee Carriages to Cemetery...@ $
* Date of Birth. . sah wee et Wiper eee Automobiles te Cemetery. og -@ $
Wagon Deliveries ..-++ils 5 Ait evwleertaviele ss
. Aged. . 3.2.. Years,.++. &;:+ Months,. Avieees Days. . City Calls’ (Coaches).-+++++++ereerseceserstes
Name of Father. .c.+ 9. be ketdcters. 4 Death Notices in....Newspapers...--His Birthplace ...-+++Low Reber tii vhs easels,
ae S89 Mi Names REE ee SERN, Ma PR ell =
Name of Mother. Leer
Baatait.
wee . Flowers .seseeeeees 4 dL esta wie berelaspiece SiC we EL Se Oe
:
(Maiden Name) Outlay for Lot..+-+;
; Her Birthplace ..@-r@rhewsisecererceees
seseeeeeeee® . Opening Grave or ee ST id lna ets, i
Body to be shipped to-+.+-+srreereereres
secccveccccees’ . Lining Grave ..+++-+es
Size and Style of Casket or Coffin. .--+++++++++ Saline ces BVVETLOEH = v's a:itmin citieine aitioreice aesins seit eh
}
13.
Tent or Awning Charges
\
Merete Cees os Lede gp eirndldeie ling tie daaeies sevice he Ach 00h aes ke altalicny Wha. hcaiaseeieses anatase ened
Manufactured by...sesseeeecerccenescersceeesccesers
Shipping Charges, prepaid
Interment at .UArerrerm.-ATT eee Cemetery Saas vine Sa Seb rases eer ccccaeeesescerses
f
remation Charges ...-.-++eseeeeeeeeeeeeees
Lot or Grave No...--2+eees aay ND. deat eataees Biihve Bohl. aca Watchers $
Personal Services ...--Cas eae ata seh
= 2,
Music
<i
OF 3.
Church Charges
: ar
Br sealer eR ha Sine he FL preccete owe raeley 4958 tin tiga Pacerersyp site ees Peo? Fo
x Be ie peeees, RE etiy a): oh . ona peAn WO Ce siies CRb awl y Bees otitis te a's ia ee Hall am
8.
Total Footing of Bill.....eseeeeeee eee es Wile eoat calteaeece
Diagram of Lot or Vaul
hos P 7
; Designate ach op in Lot with Numbers (1, 2, 3, 4, ete.), By Amount Paid in Advance, ...0 eee eee ee ee [ence er 0, (Poe
and mark space for this Funeral with a cross (+). 10
i
Bg Designate place for Monument with a small square (-)
Balance 20. cece cc cc cee ooo os . ]ncetscesecenennss . soseenenen oa, ,
Use space to the right of Diagram for the names of those
,
buried in Lot.
Entered into Ledger, page..---+++++: or below]}.J Jy . .22.
Acne hoe [ei aoa To Funeral Charges... Toth S. ee Seo
By Cash 1.02050 boy ceeds mee © Re see Et Pee
Ces i oN en ee eee eae: Ca nian aaa mane s
PEERS VEL Mea NP MINSN aE pclee a Ql no Ske sical denkaszanuncintlh sRvonseans of asngesoer streamer oimeaomeragnasfeatecerebeerettarnettnlseoersmisnrsss
ACER SS LORS 57 q
'
‘has Hae
Bs ee, ON Piel foros = ectciaaneaes aa: sual se Soe noi
ie
.