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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
7
182
RECORD OF FUNERAL
MotalaNo.csecascewc’ Yearly No.. G0 diay paint i. ea aia 19.2.7
Name of Deceased...Chr anh. as, Se. eee (UU re oe Sree nes aio eee : ae
(What Race) (Where Born)
Husband--:
Wife---Widow t
eee RIBHSRIORE Nine t ee Mesum ecm eres Lone Sere ee H 1 gis ae te sD lo geen inas ocouens A werel nr Siete Nigtel eeavos so Sa oS
Charge to. Ws lwemeenen oo odinsis beisie, orepbre' #0)" @asket or Goffini. i. . sa. eden owe ne dayne 08 $ AaGb. 2.0
' : Metallic Lining: ..-.006+ s see cee csee tenes t ee ieteer eres ow he
‘Address vee nee penne the Pia. pice sees g ais gaan
Grider Givets Wyn sce ack eg ree ee cere egs Sore OQuiside Box lige sces ohh aie> ome ces cummerrs tals ooere tte pegs
\
(State Kind)
How Secured sic vers scene vegcs ete ceed see emare sys see 7 CUE Niele Gai cheers se 3 one lee ogee wants ets arsed [ae ale ge oe
(State Kind)
Date of Funeral. . ©. et. Pris Soe Oe Tn HRs Heaiens clein. 0 Shae? Burial Suit or Dress. ....00scee eee se eee tiers sree bor ace
Residence .S. e-em ¥ eee enone Burial Slippers and Hose...-------+++seeceeffrrrees tees
Place of Death. 3 a ee aes ora Engraving Plate...++0-e+++s+errrrr eee LalWissms wee
i Embalming Body (with....--+---++++5 Fluid) . }..--Funeral Services at.. NbrOrreseers.. eee eee rr eet: Dreising Body, €1 << <i0+) ibe We, .f ave Wit daes
Time of Funeral Service.. (n. 0. Case. eee eee ee Hair Dressing...-+Fes A Pe) ane 5, ata . eetere
Clergyman . B peace aha fia nagenrind Use ot Folding Chairs....-+s0---sseree sree iernees: :
iF, a: : Candelabrum, $...-Candles, $...-. )---eeeee} ooo?
Certifying Physician. . S Peete atin RE Sane c Pre) Se SEER Door Badge, $...++++WHoves, Bes caleg nea lear Letee ee
His Residence..is FL: pa ee tine Oe ase) actiy Sac FU cATaG esses ce a sitiabeawclas wile iaiwis » ated « slane cola iieean wens
Number of Burial Certificate...------sesseeeeeetrtte Auto Limousines to Cemetery. .@ $.--.-++++++[errrrere: neces
o Pyke Autos to R. R. Station....-@ Biss Soc es. . -s een edhe
nting Gf Deaths soe suai cess te ees tae Se emnerroy «ie : *
éprimary) iden snaaer) eo Eom Service ee gage, ee, Meee reel se SiS . Chacha eae
Aeroplane Service..++eeseeeeesreeersrecee: Olfisess eseclib = ois
Date of Death. .@ ae a s(t er or Ca Path Noted i. hors cB SU aan I.
Occupation of the Deceased.. WA weeereene vee ceee sere . cee eee eer eea ines ce isuperay Ty
A * Ee (Names of Newspapers)
Single or Married. S+s-%.-. . Religion. ..----++++ +500" Flowers, $...++++ Rental of Plants, $....-.l]-------+-] +--+
Date of Birth. Semon.. tanta.. I AT he dey Pare aaPecr eee Other Decorations. ..s-co.eesseesesceet reese . ereeeeee:
Age. ss se ¥ 3. ie. ee vi y eae, Months. /.&-+++ Days Outlay for LOt...sccceccseccceee tesco trees elec eeeees[ sone
: Opening Grave or Vault...ss.e+seeeeeerr eres . feererees
Name of Father. M+. heer 1 Stet teemme so sts Lining Grave with Evergreen or Muslin.. ..4. Ws..
His Birthplace.... 7m P. es Miles. AT Naa sas! Matting, $...-.+++> Tent Rental, $...--++-l.sseeees
Name of Mother.....+-++> Sater, Piste sts Be dbes aiecee anion eeeie cee ous Use of Lowering Device....++++++++seeerrrcWerrreree:
(Maiden Name) Rental of Vault bela 0 obo 6 O60 wale boas grelare 0606 5 914 > Ihe omaenie or hire ©
Her Birthplace 0255262. 0 .cd Bese een aan ssn s nnlebee ns oes vaca ee Charges. ..----+ese creer ieeeeeee es
“ emova AT GES. 22sec eee ene tees eee e ee eeeeeees
Body to be Shipped to...2--++++++ ye a ee est, OTL DS 8 tale ek eaOarer am Meme
J scdce Ba Pane Ma Ae G lereperechl Fras! poapas e's ©» je tating s © =" esegnsnomey a) 908) 80S 2 Personal Services. ..---eeeeeeeees eer testes enteeeees
Size and Style of Casket or Coffin. bed Be ae reel QiNGOPe! 5 aces cae xe = rite ve Oe Ye 0 Fer ee oi OTN Sie nivale ee
R e Church Charges, $...---Minister, $5.6 ces Ss . . ocr eee
. ~ 5 . BO ES i aa ea Telegrams and Telephone Charges. ..-+--+ ++-. Jeeeseeee-[ eres
_ Manufactured by. Sr Ree. Crate hd.. Gr. +s Pall Bearer Service...-----+eeeee ere ttt eeeeeees
Interment at . { <li Pe OT 0, ag © Cemetery Soe. Ligh asafale 47 SIDER PRAT AE Sar ahe, pcb suAr ere ie28) *NelBed Sele AUN Henini sm Ay
meen me ret ake . Rei Dinca Smeg ain cane SG ae ee
Lot 5 eek Me ee i ne ed ICE I ACE Sel aR aL Spagi 2 Mlel eS pam . ay
ob. (4% Oe ME Tee al Ee Total Footing of Bill......seseeeeeee eee of a fo. PO.
AO rs ak ae By Amount Paid in Advance...-.eeeeeeeees Shed caw shes exe
l Balance.. 5 asec ve ween dee 08 . anes asd
armel eA ay ee eee apnea Sr
Entered into Ledger, page..-----+--> or below. . ....++ aiare
DEE ge cacn siete aes) 6a Eig ae gy RA bn tC OUSie e's) & eeimerene ene Ere tee bie = .
. To Funeral Charges
ee eee