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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

Total (NOwas soess ves Yearly No. fO?.
Name of Deceased.. > as Arkfe Ar te
Husband--Wife---Widow t
Son---Daughter of
Charge to Guaele. Bandiana ince waite te blot hae
Address ....5 LN GP afi oie COWL seeraalbalulgiade epee se,2
Order Given by... 5 diire SiGe ik are ao eee midis hie gly y . «
Flow Secwred bs oie. iste dauely 0 ace eek ons one oitiy wieine 646 wom sie.»
Date of Funeral.. f+ s+. .7
Residence .... SHG Sa ricoe nied t The ds atietelne ew erpie's
Place of Death.. +.). Sige By) sek eh tees shan
Funeral Services at.. S¥rtarte. cee cee ee eee eee
Time of Funeral Service.. Ga Str eee eee
obs Pew Be Rea tetats aps wba bs cenit es Heine a0
mide ee
His Residence. ... Mw. Rev ccc cece ccc esc teweeseees
Clergyman ..
Certifying Physician. .
Number of Burial Certificate.. oo.. .:00. ccc c cep cence tio ease
Cause of Death(£. "Saliva
(Primary) (Secondary)
Date of Death. .. Naanc:.2.08.)-4 WM.. eee
Occupation of the Deceased. Ione
Single or Married. . met: ; ee ye MOET wpariiicen oan
Date of Birth..Q. ee ee Shee Gee reat ais ol
ry OEE hah, Years. ahs .cx Months. .J.b...Days
Name of Father..: \ ‘ae Ko ay es ee
His Birthplace.. ..06. SMITTER eee cece enero e ees
Name of Mother. sda tee
Her Birthplace. . 2.0.. NIT EATE. See ie eee cee e coe cnes
Body to be Shipped Sh bas yy fis AULA sla grew cidacictecy: Oreos
(Maiden
Size and Style of Casket or Coffin. & . rE, nee Sere:
tur eh Ree: BATE on, oe ee A
Manufactured by. .
7° OA
< uv ‘ a
GAVE NO bien . cae sdaiet ss
Seation NOs.. Faas et ele
(Where Born oe ee See eerie Pers ie
te dCi ere. Oe 0h a SP OWA K ObO we CONSE QI MATS Ter Slulglé.s bole ve @iw iRise © CN MUS. Whe RIGO RIS ¢ SoS RIGID IE RGEC LiOi SF YOR PB aS Be? ¢.e'y clears ee
Cantent Tor COM ucatinices o 5a 'e wcctole suse piss ererdia'e areie $i]..
MLOtAUIC LAMING Walesa 5 wok + See Fld Siete w sia wes
VUTSIG SSO, 5 2 ces Pisin y cic ovata tees acest kere se ware dime
Grave Vaults. cc. wep Ge po debe wae ehneeaieras ey asst
Burial Suitior Drese. 0.4% + ee ewe eee Cees 0:23
Burial Slippers and Hose.....6..eeseeee
Engraving Plate .% sis s 0s cea cise + vale 8 viele oe"
Embalming Body (with......+-.+Fluid)
Dressing Body, $..... Shavingy8. oie en
Hair Dressing 0.)rtc ells bavi: cate bee G, slviate 9 Vier
Use of Polding Chairs: 0.66 000s <2 bd. eels
«© Candelabrum, $.... Candles, $....
Door Badge, $......
TRGB GE Solin eee has w/the oR alr ore.9: 68-5 Minas
Aeroplane Service. ....00ssceeeererceeeee i
Death Notices in..... Newspapers....-(Names of Newspapers)
Flowers, $..... Rental of Plants, $.....
Other Wecorations-& seis < esas care ote s Mine vaste
Otay TOR Ob al a) vtatece preted > <9.9 saitemae's Eales
Opening Grave or Vault. ......eeeeeeeeees
Lining Grave with Evergreen or Muslin.... +
Mattitigy @.. 3. Se t\e en Tent Rental, Bs. .ideienevier «
Use of Lowering Device. .... 0s scneeeeeree
Rental of Vault... eae PR ie) Se a Oe
Outlay for Shipping Charges.........4.
Removal, Charges, lies: wines nwt eaeerg esas
Incineration
Personal Senvicesic. o.cecjcle« ae ail gle eee s Pasties
Gin gers: ois laches eeeeldsereals's ealenarnipdns ise oslnig sieie's
Church Charges, $....Minister, $.....
Telegrams and Telephone Charges.......
Pall Gaver GOrvices. vec xctae eee eihisle onion Fe eee
Venn dat Sembee: teagan
Total Footing of Bill.3.0. i450 ase mee sae ae $]].¢.
By Amount Paid in Advance.......+++ $
Balanee rs tccwaite Wyle aces osc $
Entered.into Ledger, page......-or below
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