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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

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(Total-Number)
Name of Deceased
Number)
ear eeeseeseeMeccselesene
* Wite--Widow
Son---Daughter “OL
Charge to
+++++Order Given by.
HOR PHRO PORES E EHO E HEE HEE EH EEE H HES
seeeeee
er rs Address .
How Secured ..
Time of Funeral Service..
Clergyman LRGs
Number of Burial Certificate......eeeee:
Cause of Death. als paveleiw aivie ee weidielyi iene mat. arepiet
Date of Death. tac Ce
Occupation of Bis alsiss hoi vimieie ie civiais aivia bles 6a wie ob at
_
Single or Married. 7. a77,..Religion Fo et ae
Date of Birth.. / thet AAD ay less
Niles cvs fie Velicas vos aso h Le. Davi
Name of Father. LIME..
His Birthplace .....
Name of Mother.. &
Body to be shipped’ tos 0 ci. Jua'eweine peuuvie'eaees Sedieuinesie
Size and Style of Casket or Coffin.....eseeee000% Fibs
eee eee ee ee
,
Manufactured by..
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 (i)
Use space to the right of Diagram for the names of those
buried wr Lot.
as
Frist of Casket or Coffin.,.......
Metallic Lining: 0.7) 7 ccanie's aay otteeens
(State kind)
“Outside Box
SSGrave WAU ccs vbasecess och ba slevehoo?,
“ Burial Robe ... karen
Burial Slippers and Hose.......
Engraving Plate
Embalming Body (with.
Washing and Dressing..
Shaving
see eeeereee
Co io
Pewee reer eseseserssese
Encl Eodviee Tos fed. cc pines styl rie:
Disinfecting Rooms
Use of Catafalque and Drapery....
“~ Folding Chairs ..... sahinck's
“ Candelabrum and Candles.........
GIVER Goi cots ac aeue ye OTRDE Ss sak swsecived+«s
Door Crape $...... Canopy $....00005
TECAYSCS win s'o.4;0.5's basin Koss o'veles Cy'lede cue ek oe aale
Carriages to Cemetery...@ $..cceveceess
Automobiles to Cemetery..@ $..eseeeeeeeel. ..
Wagon Deliveries .oscercccscvcctedecesevcsece
City Callsi( Coaches) s.ssic'e sista sie’ seeesbeceies
Death Notices in....Newspapers....
(Names of Newspapers)
Blower en 235 tare ice aes sbuele ioe sleigis sie Sloane eehates
Gutlee ior Lobia w cao! bseee ee
Opening Grave or Vault....ccccccccccceces
Lining Grave ....+0+.
Evergreen .....05 Ries oe cig alent
Tent or Awning Charges......seeeceeees
Vault Rental <atiee
Shipping Charges, PIOPRIA +. ergecqeetccenenss
BEMOVEl CHASER: « ols\s aigtll's en v doe eaeaNtoe ales
Cremation Charges .....
Porters $...
MEFsONdl SETVICES® one's vies suv eodeenelaterwmaeen
Church Charges iisin.sesevapeecec tans cdvencnh.
CTP O PO eee wearer ereres
eee ee ewes
eee eee ee ee
tee eee ee 2 a
Total Footing of Bill
By Amount Paid in Advance......e000
Balance aieiesse eerie
nigtiodyey WMUONERS $. 56K eciee compu a
ee . peneennes
ee ee ret woe
Sonn One nr erie iri: . anes 1974 rch
seeeeeenengeneetes
Entered into Ledger, page...../..or below
Lhkx
To Funeral Charges.. . Total, $ TA. on BZD..
By Cash dh MORE star'otp ea a
t; AN i Re ae 8 Seer AD ee Ek i
fy te
4
(ee ey
+
hooey ee
Names of Pall Bearers