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Collection: Original Records > Death Records
Mortuary Records 1925 to 1928 - Book 23 & 24 (277 pages)

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Page: of 277

RECORD OF FUNERAL
Total No....2s0s Yearly No. oe ae Date. . 77. PG A Seas cos
Name of Deceased... Yb.. Akce <. 4 te lcth Aa w Lat, Gia s. b al araeee ate acvis'n eiareton
(What Race) (Whe
Husband--Wife---Widow t
Son---Daughter BE Gah oniates Whig AN Rises ¥ SiSie we Ape OSIRNE OS:6 aie" VES Sid Suse nie aaTeNe mE Mie oie] of Seiahgiegeivin = ap wae ee Fee ee iw is R HERO ey tattle Shep ely Bens
Charge to.7¥.-. 3%. Arms. 9S) aCe Casket or Coffin..9— sArsanark. ania <atevae lobe $]. .4
Address ...-. , eat tee, FIRS ere e Mle © 0:6 ool els sc. plete elm © Metallic Lining SiC Cl evere Sue) 16.8 a8 (Gtate ‘Kina Bie BS: ou
Order Given by...2..00cccec cece cect cere ee sececeens CUIRIAGHIDGR + ahs snr +2 a ciersiciets 3:0 pans piaelednn are Sates ste
(State Kind)
Flow (Sectived 2. .<scsne ssi sti o-cieie cl tei 6 oo Sjelerppet cts ole ove sfajeiw ee a US eRe ee np ee ele SJ» ME eae .
—_ State Kind
Date of Funeral. . Me me. AIRF ie ene Burial Suit or Dress..... ree iat iil cosa
Residence ... Pe Ce sae hs inne ips amine ss ses = Burial Slippers and Hose........+++++Place of Death. @@:. 2evaqetak Sere aholGllot ss we aan Engraving PURE. 6s oe ed ov ag denser teins wenesen
; Embalming Body (with......... Fluid)
Funeral Services at...2¥-. en Dressing Body, $..... Shaving, $....-.
Time of Funeral Service... pT: ohh art i ne A Hair Dressing ic,.< j.'s smece pls d-alviers one's aie swine
Clergyman .. . MUD. mane ene 000 eee cece eee nee Use of Folding Chairs....-.+.++++++seese0
ee i ‘ ‘ «« Candelabrum, $.... Candles, $....
Certifying Physician. air HL Be ls “Fees ee ae, Se Door Badge, $....+.-s lowe 8. os face
Flis Resitence.” SW Gee 25 otivs So oan bara ores wees ingelae EAB RERC sl ocak thot, Sy Sage ahs eT BER s Sie os ORME aes
Number of Burial Certificate.......gseeeee eee eenees a sar eee . 3 Cemetery. ye ; Pg eke
utos tows Bo Station. . 4.. @u@y v0. Sek. re 4
Cause of Deat hc tod. « he Ore. Cert are Ae.. : ‘:
ES ha coeinasy) (aconanee) Other Vehicle Service Po crc lernsaline aera v's aieie sinless 8 east
Date of Death. .. Neat.. mB ec cece ee cee eens Acrapléne Retvice Te lek a {
Death Notices in..... Newspapers.....
Occupation of the Deceased.. CA.. Qe aes os We Th Coie Rue uc Mens ath, Ne Ue
. e f ae (Names of Newspapers)
Single or Married. .W eck PROHGIONS. . sigan ed sat satin Flowers, $..... Rental of Plants, $.....
Date of Birth..swag-.% 5.. JESQ..... Other Decorations.. .....c0ccceseceeeseees
Age. wk. ; ves V@AYRi:.4 8. .. Months. .9.%.. .Days se Pie : -Y . it ea Vad fia cl
pening VG. OF WMDs o:c gle ew minaly scold see Sues 2
Name of Father. eet ae: BD. anky... Lining Grave with Evergreen or Muslin.....
His: Birthplace.c. c. Sho. Wks cg tkorp ors cons es tees Matting, $3550.. s5.0 0% Tent Rental, $......
Name of Mother. 2 Q: ‘See he Use of Lowering Device.......ssseeeeee
“(Maiden Name) MORES OL VOLE ells fie so < 5 Pe Smeets wiles. vel rpee alevoe
Hise Birthpiace £0. Mee, 1a 08 cick sco apegs ve co eee >t ated cp telat Charges...-++++++++e0ea emova RON ics athe Oyines Wighlth ang eb el Seles
Body to be: Shipped ita. <.,. . -raiaeaielhin ds Fees poo See oo bless FistihientSet cy, Fer eet Oe Nm oa te
bse gua ois! SENET RCA RSIS S46 GratRlEle 2.09 2 bie bus ois © RUE exihensuelel wei else's 4 aches y Personal Services......c0 cece ene eeueeenee
Size and Style of Casket or Coffin. aly ee din deiety oisieth ses Seas Singers .. 2.. eee eee eee eee eee eee tenes
4a, x Church Charges, $..... Minister, $.....
Sree Re Ses wre equieced TO Sak Ted ght Maire « To uicie lene mili Telegrams and Telephone Charges......+++
Manufactured by. os Pall Bearer Service.....-.--+e+seeeeeeees
Interment at . S&P Slakey wn 4 ao oe VeteNs orale (ire a ia w) epia ees alsue Sule = Were 4: edie
es Total Pooting Of: Bilin oo. 5055s isle ieee wip se
pee
By Amount Paid in Advance......+-60++
Balance yo%< face ssis als 5 4:5 205s ae
D m o or Vai
nears = Entered into Ledger, page....... or below ee ee ee a
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