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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..-++++ ra Yearly No..--9.15. Date.. . Vewethe.-. . a pets eh tag 3 19. a.
* Name of Deceased..-B~4 Sahn : 1 Sees ee : Wealth, AR WA St chad comeate c.akid BA
aushende(What Race) (Where Bor
Wife---Widow
Son---Daughter of
}
Charge to. Ba cua.» Meena fot Sc Hall ste «sisters es Casket or Coffin. «2.25.25 -+20tenccesere
terns $I. A.A Oo
ae ee vee ae
seaeatiis RAMA oes Pics > otnak dca seer ee gaRehanah #2
: Address ..eO-. .-}0=
PAGS 6 ois 5 iors w slennrerm ae Lainin
istate Kina)
\ Didar GloMi by asa ns Ste amma “yates she ee 7 Le Mir Sp aires Soy SE CY ea ad alain ela
i
(State Kind)
i How Bored mae aoa sles saan snmeme eee ORT Gare, Veda lib aon sweaesp tte mert toes tsenp neat eng eS
(State Kind)
Date of Funeral.. tewae~ -*H.. A.A} sige Rise sees Burial’ Suit or Dressy cs).. acess <r eee sese cet a grO. 2.4
Residence .. We.¥.+-Carb wnedee Bas cllat es <4 Burial Slippers and Hose..--+++-+++ssetrt0
> Heed aes . e 8
Pinca of Deaths. .8tscddeacheeters
ss Sagal A, ease Engraving Plate...--+++ssssrrrerrtstte
ts: ee
:
. 0 Q Embalming Body (with...-+-+++++s500+
Fluid) . }...----] +++
Funeral Services at. = athaarks < PI gi aa Dressing Body, $..---+++Shaving, $.-----+--. Jeeeeesee
Time of Funeral Service.. -: OO
Tate Dressing ws 0) cam scien eto eities set ones siete amb errs
Clergyman Rav.. 0. O° Ru th. i: A) ae Use of Folding Chairs....-++--ressrrrerreeeppr
ets Oran
«¢ ¢ (gndelabrum,
$...--Candles, $...-\Jenereeee
forte
‘ Certifying Physician. .. Ar **. fee ee a A A a Hy tei Bibles, @. lem Gloves, $
His Residence...--My gen Ree c + onl a whim womeieins. ae Ficarse nt Benge nach hee eaeeetes mere rigs Same Tena %
Number of Burial Certificate.. ..--.++srreerreerse
Auto Limousines to Cemetery. .@ , Coo ae Ra Dc A De
: is
f Autos to R. R. Station...---@ $.. cee eeeee Raw cstenveir} eaess
Cause of Death
jhe i dee chao BEN . ack
: A
Proar panera).
(Secondary)
ea Service Oe ee eee oer . omenk y
eroplane Service...--++-++srerrrerstttt
alloc seers
Date of Death..: 7 ty (Sees for A Are rors
ae
: " ate of Death ?.
L 14.2 7 Death Notices in..----Newspapers..----++. Jrrorttt
eee
Occupation of the Deceased. . SIE cae die eis td che Lids cae aT va es ea tring Se ea
°
ame
(Names of Newspapers)
Single or Married...--a Religion. ...-.0+¢4e5ee2*
Flowers, $. 0.5 -++ +: Rental of Plants, $...+++. [-e--:
Date of Birth..fe, Sa . May: de 2: Othor DeGorattonse c.g te one ooe sees ah es lose ns enn ebees Nt
Agett, —&. Years... i] [. Months. J 9 sas Days Outlay Mae Uioke alge nee vemeel esas ass ow mercial Pesce 6 > ae
4
Opening Grave or Vata «ccc ove old oe dee wnige eile see twee
Name of Father. .-]. @*«.oc
Lining Grave with Evergreen or DEAT os aves SEU ceases = 4]
His Birthplace. . L. Dacerhe tranches 7 Aes Ee Matting, $..-.--+-+> Tent Rental, $..---++++lJeeceeeeepeees
Sdadat of machen: eet Sf nea oo ane Use of Lowering Device.. -. eect eee ect e ere et feeeesees
areca Sou
Ratal Gh Vaulbes on seat vate st is sitet s eerie seer oe 3
Her Birthplace ... ya
ae AAR, md Outlay for Shipping Charges. .----+++++re seer siersereee pees
j
Reutoval CHATBOS. . owe <tc cs yes oo sa nee ree tel angess
Body to be Shipped to....--s+eerrrerer
streets
Tectmsatiafic 4) ce eceeapes = n0 Goth ove Ope eased
7 yoo MERU Ih? WE go ernip yee etic? ne «ake ies Are geen. SL Personal Servicess. ..4. +. ss ssee erste eee rte tocnteess
Size we Style of Casket or Coffin. . 4, 3B a AOL. SRL AROEW oe ie eso page sage soon eee = + cables she als a eens SoSlae
sh
S k Y) l s Church Charges, $..-----Minister, $...----]]...+5ttt:
° Shr.. BN. pein & reece Leap . ra Telegrams and Telephone Charges. .-.-+++++++++. fee-s00%
‘. Manufactured
by..-BAA ios. evens ere = Ser Pall Beare® Service.-..-c---so0e
sector ence se [tecnmes
Interment at ..--rae atl. Coy, a). less ca Cemetery) --::;77o
nga eae se Fe wd yh RES NONE Serre
7 Ht . 747
ne ee eee, Oo Total Footing of Bill....-+++2s+reerrterte
$l ZA “O.?
{
Seation No
By Amount Paid in Advance...+.-+++ee0009*
r . Sees eae vee
. T
:
Balance...-.+eeeeersteeet
Scere peeis
1
ee
ere
a ie :
Entered into Ledger, page..-----+--*"
or below]. ....-A Bie,
Pte, as Sends ieee dias staiavelgaereis
square wong # ar oe eee Tee Ae
.
To Funeral Charges
>) Gece
ialeeaen Men Pilar Ph