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Collection: Original Records > Death Records
Mortuary Records 1919 to 1926 - Book 17 & 18 (287 pages)

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Page: of 287

(Total Number)
Name of Deceased OUbheue
Son_Dewgimer of ge
Chatpectos). ¢2.cas « sclesingdes siete dives < cee cane ualha awe P
NGMPESS” Ire aisles ite Gages «cere # Ree tAwe he ale ae oleate sé
How: Secured: cs diss eicins tak re ee eT eel
Date of Funeral. aatle. L Dek ans Tie Si hte
Residence . BhthbatAnin§7 Suis Saige aa eee ate aus
Place of IE ec aRRE= R
Friareral Services atsisiaeit ie cast Sein bScn Meine oe deg ees te ciel
Time of Funeral Service. ys,
Clergyman ..
ee eeereroerel
Certifying Physician .
His Residence ..<
Number of Burial Certificate....seeseeeceeeeeeeees “
Cause of Death...... ;
“Yate of Death.. GELLCA.
Occupation of the Deceased.
.
.
.
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.
°
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°
.
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.
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.
Single or Married Religion £<
Date of Birth. ie jth Libis
Aged.. Sas Years,.. ¢@ Ae Doma le .Days.
Name of Father Wx Toes “Raa He CTs ee Toor eves
His Birthplace .¢000e<t Vie ocscesfescveccnvecsvcsses
Name of Mother
Her Birthplace Ty hee
Body to be shipped t0-+.cseeececccvcescrescccecvereees :
Size and Style of Casket or Coffitt .i:s.0.0 sie.0is ¢s'0c cee ceeh ee
iden Name)
eRe ee ewes eH Fo ees ese eese eee eeseHseeEeeEEaeeEeereseeee!
Manufactured by.. RE Oe ice ee CR oe a “tr
Interment at . Sia eS hit Moe. Geokies:
Lot or Grave No....+++ «+ Section No..-++seeeeee1.
2,
3.
(What Race) (Where Born)
eseeeeeeesOrder Given by. ie
* /Alearse. .
4.
5.
6.
a .
Diagram of Lot or Vault
Designate all Graves in Lot with Numbers (1, 2, 3, 4, etc.),
and mark space for this Funeral with a cross (+).
"A Designate place for Monument with a small square ()
Use spaee to the right of Diagram for the names of those
buried in Lot.
“ Outside: Box -s.2.5<.%.. nik a Meeeisin we
(State kind)
©: Grave Vatllt osieccuuebses Bn MARA:
*: CBUSIMIORODEH lage et Nole-ce eee se aes
“
Burial Slippers and Hose.
Engraving Plate ..-% by eM esas ee nese reeeeees
Washing and Dressing...sccecseeeeeesecees
Keeping Body on Tc€. ss seeeeeeeeeerees Rate acute
Disinfecting Rooms ..--++cceesssnssesss aS
Use of Catafalque and Drapery......2.++:
“ Candelabrum and Candles.... 5 Seaiaiee lg
BlOVER Fiscicis:c vias savas d CLODE Bo vw cm vc ve'ced ces
Door Crape $..++4+++++-Canopy Sg. itaitennte
Carriages to Cemetery. se ees GD Posesdecesaeses
City Calls (Coaches)...sscesscsssgececvecess
Death Notices in....Newspapers....
Peewee eeeeeeoeserereseereees eee eererereneteeee
Clemninad Newtapero
PIOWEGS (6.scccees ecco sistas
Outlay for Lot.... a
Opening Grave or Vault...cccccoescrecceves
Lining Gravesin vsce.cice seuss a oieiaplaatere eels asco
Evergreen
Sewer eres ress eeseee
q :
ee ee
Vault Rental ..... i ealbe te eaisitensp etorg'ets isin otacta
Shipping Charges, prepaid.....eseeeseceres
Removal! Charges: «a6 cg.swie<scis'ssleisiesiee's seatepee
Cremation Charges ....+dseeceeeeeceeeres
Porters $....+ «ee» Watchers $....00ec0e
Personal Services .....
Music, avg. 35 Saale clas 9 Field a alate ate tree Vente setae att
Church! Chatces) . sid i: casey svasae cscs vesusies
ee
ee ed
Total Footing of Bill... AR ee eee
By Amount. Paid in Advance.....eeeeeeees
Balance oo els ioe eb
Frice of Casket or Coffin. ARI Sona MS: UE a) . ee
Embalming Body (with.... wc seeeesFluid) . }..
SHAVING 0s hsiss vos aig Snips cinta inte nlwielesalaie sle-t'etuly pe
CoCo oe eeree Coreeserseeeseseesee se eee il nnn
Automobiles to Cemetery.. @-$.,seeeeeeeee eel] cncaneann
Wagon Deliveries ...eseeseeereveeseseeeveall cnn.
Tent or Awning Charges.....sceeeeeees ag
saneneeren street
aseveceseazespeves'
er ROUSING, CHBIES Gas sare er6 gn vet nie'slors's 'e's ¢ie-aie6 . fpecct crac . S :
Maa @. To Funeral Charges... Total, $ LG? a. Vas y