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Collection: Original Records > Death Records

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

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Se on — —— . 6. Wold iets) lumb Name of ae Wd. Wn, sie peswee ) Colnarlea Ochre Charge to Address How Secured ..p...cececeegeges vieiysiave Dlsia Sais ede pawl 1 Z) a4, Teese cacece Ce ae eet eee e wee eenne ee i i ee ee . Date of Funeral. Residence . Time of Funeral Servi ites Clergyman . dad ‘Certifying Physici oe Sarpiste shelnlela.e ts His Residence me dives gu cmreeepariceest Number of Burial Certificate....ccssssccceccccccces “4 Cause of Death.....56+. Date of Death Occupation of ee Single or Married iz peg See A Date of Birth..... ke 32 tas ee Aged... 2) Y@ATB, que OM hs,...::..Days. Name of Father. His Birthplace . Name of Moth Body to be shipped to--..ccccccccedecccccesscesecceces Size and Style of Casket or Coffin......+-++-Arehin 5 Manufactured by...,.. Interment at hh 0 ‘ Lot or Grave No.... 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 (+). Designate place for Monument with a small square (a) y Use space to the right of Diagram for the names of those buried in Lot. ca 4 Date. «e+e+-Order Given hey, Lhasa, Price of Casket or Coffin... its alae shag hie eis $I]. FO). iz 2. “Metallic Lining ...... oh IR ng ae a ae Gtate kind) 3 “~~ Outside Box ....... sale Verio sas Rake At & ha (Seate kind) bei Grave Vault .....0. +000 veslees r (State kind) s Burial Robe ....... sebcieieis-aineinle “ Burial Slippers and Hose....... Engraving Plate Embalming Body (with........-Fluid) Washing and Dressing....sesesceecseeecess HAVING sea ceoitind dsie $05 spoetaopuises aneen bebo ss st Keeping Body Ode ois 0cos deicissiciege ss eee cen' By Disinfecting Rooms ... « eniets Saleh eS epee aerelde Use of Catafalque and Drapery......-.0+5 “ Folding Chairs ... asia ivan aie aleletsyd w siviaiery “ Candelabrum and Candles... oe pisiusse' wets Gloves $... Bisiew secs « CYEDO DS. 9% Door Crape $.....0+: TLOArSC rs. wicwt o's eens pees eeuinesicns Sa sinisienalvies / Carriages to Cemetery... tees scegers Automobiles to Cemetery i. @ @ $5 rz, Wagon Deliveries City Calls (Coaches)...essesececsccevecceses. . .. Death Notices in....Newspapers....: BJOWORS! cies deivasic cinvas sce 8s Outlay for Lot....... bee aebhies e543 tal Opening Grave or Vault. Lining Grave ...... Evergreen ....-.e-e0 Tent or Awning Charges.....ssseseeeeees Vault Rental .,.... nae : Shipping Charges, prepaid.....2 Dade eeeeeees . . Removal \Charges i. «0/00 0.65 calgetarn ecco seine sitesie’s Cremation Charges .....ssseeeesegeceveres Porters $... eeeecss Watchers $.0 Personal Services ... Music ey eee rr ey See eee eee eeeeeeesesner Total Footing of Bill....ccseseeesseceses $I. By Amount Paid in Advance......20 Balance isc3soeseese ieee Entered into Led RDERC. cash gcse nt or below].. .. To Funeral Charges... Total, $ 2G eg eee errr erro ot toes eeseeeees. . .. Church Charges ijeccccle basse sis eescpedtee mona: 3 i ry Ce i oe . be Ce . eee: Vf