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Collection: Original Records > Death Records

Mortuary Records 1919 to 1926 - Book 17 & 18 (287 pages)

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vs 2 f Name of Deceased Wife--Widow . Som---Dewghter-of f -/7* BS --and mark space for this Funeral with a cross (+). "No. ‘etal.Number) weeeeeeee Order Given ili ns Pee ee eovew Charge to , PAGUPeag i Ur critics pee stsife.s kus oles Whste ules caicie st9-ea)a cies Hows Secured) sUsae cnisiesy ssiethit-s es ogevicles-onisisie's edie «evel Date of Funeral.. A¥47..45. Residence .. Place of Death. sgh ere Funeral serrons at. JP f a: ii igs a Me Time of i servi eoweereeese) een eeteore Clergyman .. Certifying Physician .AAZ 0. fi PDH oer creeeee His Residence . A ae Ga rg gi nee: \ Number of Burial Certificate....cecseeeeecserececees i Cause of Death. 62:06 0.004 00sie-0 bd gobs sia Wie Stalid sos wawia. o elbre i i (Secondary) Date of Death. Kit See Caaslelaitie Mn Occupation of the Deceased 5 haeienie ei Single or Married C2@eya Réligion Bl uldadorce: Date of Birth.. Spiele alt el Tena tus hr Saree a tele Aged.. 7/.. Years,..... Months,.....Days. Name of Father.. His Birthplace ... Name of Mother.. secre ett eeseretessscesesersesencess ee ee wer eresoreereoeeeereesesereeere Her Birthplace .. Body to be shipped to-+..ssseeeeceeereeees pisces Size and Style of Casket or Coffin....ecseeeeeeeees ee eee ee wee eH EERE e EEE HE EE SEE HEHEHE HEHEHE HEHE SHEE HHH THEE EE! Manufactured by...ccecesverssesrccssececs 2 yw ee Interment at . LAMA Te! ..Cemetery. Lot or Grave No....ee0002: Section No..... Bad 2, 3. 4. 5. 6. “Sate oe Diagram of Lot or Vault Designate all Graves in Lot with Numbers (1, 2, 3, 4, etc.), Designate place for Monument with a small square (i) Use space to the right of Diagram for the names of those Price of Casket or CAffin. ...ccccccesceenees $$) ZZF “Metallic Lining ...... Dieuiein sew ar aia : Gtate kind) “ ~ Outside Box . (Seate kind) Grave Vault ... “ Burial Robe .. “ Burial Slippers and Hose......-. : Engraving Plate :...+.sessseseseeeceeeees ; Embalming Body (with.....+e++e+: Fluid) . }...£.@ Washing and Dressing.. SHA VINE "Unite wield vis een ools Sok sige lath elgipte ere dberete ts Keeping Body on Ice.....-.Disinfecting Rooms Use of Catafalque and Drapery......+-++ “ Folding Chairs were ene eene Gloves $.. Door Crape $...0ee00++ Hearse.. Carriages to Cemetery. Automobiles to Cemetery Wagon Deliveries City Calls (Coaches).... Death Notices in....Newspapers.... ee ereeeeee sees eee eese Outlay for Lot... saisleisisinsew's ep ele ey A 8 Opening Grave or Vault....csceceseeereeee Lilia: Gtave! occ kee «096s ce¥vced ieiv son's ees Evergreen ... =e Tent or Awning ‘Charges scnrleleters ARSWAR AG Abe Vault (Rental 033 sicsics ose-svece e's ee wreihonmaretlarets Shipping Charges, prepaid.......++.Removal Charges .. * Crematéon Charges ....+.seeseeees ae ews 5 Porters: $. ots esis «s .. Watchers $. nrauretels Personal Services nf Music eee ee ee See eeereseerseseeee Ba reriay'ss Seereccenes By Amount Paid in (KEge2 Total Footing of “ Candelabrum and Candles.:...0.-+0005 en he fa 3 To Funeral Charges... Total, $ buried in Lot. 203.