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Collection: Original Records > Death Records

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

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(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. . . . . . ° . ° . . . . . . . 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