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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
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RECORD OF FUNERAL
Total Noteiwealas ts Yearly No. .3.Q..
Name of Deceased. Wwe ... Benn eoe ss
ee Pe 19.2.
' MA UGE atBBN ais amo aOR 9 rile: 6a rom ised MOTE Ae Eee)
Machendie: (What Race) (Where eel
Wife---Widow ‘
Son---Daughter of J--+sscscsccvec sewers eeesesseeesasececcsv eres ereter er saenre ation emowseersserserressssrerarrerereteres
Charge to. +n 4. sen.. Seurre. Onaket oe Coma. Js iG attine clic ndue Upguraetl we $ 200. 6.9
IAGATBBS is ss ccveeie le sccbgiae Pa FE, ee a © Ei ee eon Metallic Lining 4 $:Q)p.e sis! stare; S68s Sainte Kind) et . Cnc BC
Order Givew shy ci os tiajele soit woes swine Motes wie oh wis A nihin e944 OUtsIe BOK asc deiee Ge rs Roig eda vlc oe ectiee nie alles ssuwcan
(State Kjnd)
How Secured ..p.sess eee cece reece cee e nese eee e sees Garo BUTS. .iad 50s Sum tics Stas sc elateale on aliens setuid eae
(Sjate Kind)
. Date of Funeral. .} mtn Vb Ae ess Burial Suit on Dees, ¥.0--b ASEM, , vedo..) 0
Residence...-.°0.-. 5S alacant ah naa . ee Sei ee Burial Slippers and Hose........2-+-0e. . e-eeeeee-. [ eee
Pisces of Death.. AH 0:.. 208 /Felger ahs ade apa: a NAH eioeai eeraeneh els aan Ape Salt aoe
: : : Embalming Body (with......... MIG) Wipers ees
Funeral Services at... te tT Ranta CR 24 Dressing Body, $..... Shaving: $5-Gived ctw wlltsaucsene
Time of Funeral Service.. /.0.. 4A. SITTT7 Ae HRA PORGU Gs wiles ao ano hntaey silecnwidie's 34 ee ogdeo:. foeg «AOE
Clergyman ... Oar. fy 2 la ee ee Use of Polding Onaits 758 oat cee s coe aces Wels « 3i]. heopsvber
nee hysici ‘) . ‘« -“* Candelabrum, $.... Candles, $.3.'. 3 + .-<il. . ests sce] os «
Certifying Physician. . . eee tee i ee Door Badge, $...... GOVes, Bi F.8is 0s sie cif. oe ee eel Oates
His Residence... Pe NOR. oS, et, a eats eae 1 Sn ene ae aS Sr OG RRSP och AY . RS Rd
Number of Burial Certificate........ saps Len ed seit oe s? Cemetery. = : seen eee eee eleeeeee ee:
Hf. utos to R. R. Station..... Ba ais sights aro crsi. . wwe sioseieraie
Cause of Death A5 oth age. ie Liar A .
ipisiatys aati ee Other Vehicle Service “hy (rah Roepe cr fi eae Aan . Nn
Date of Death.. en) OMe a See ee, aia Aeroplane pervier Bai idee ee ee ca
. Death Notices in..... Newspapers. ..... . /-++++++Occupation of (ye Decedsed... AA Aa wrertre ce . oi cececscesecsssssssettevecentssrresessspoesssee
Single or Married.. U4 .Religion.........-Flowers, $.. a Rental of Planta, SCO See
Date of Birth. span eaw.s. bee. J. EST.. Other Decorations sg) s.<2iua vette shout yeas Cok oben le on etees
CNL LOB tN soa Gatton 5 iy cons el ce, e oie oe asain
Age..f. . Years... 3.. Months... Bs Pe ree ee page ae ees te eS ceed 9
a 7 ee ps cl a Ce Days Opening Grave or Vault.... 00.. ccc eee cece lle ccen eee
Name of Father..7-~.. SOHO AAA heer. Lining Grave with Evergreen or Muslin..... ]....
His Birthplace..... Sere fj: Ede Re EG) Gece, ae Matting, Sics.ci2s i Tent, Rental, $. 0.06605. 0l. cones.
Naine of Mother.. 7 Pi eT ae Use of Lowering Device. oo. 00.. ci ee ee diese cee
(Maiden Name) \ Rental OF Vealten. 5c.c.< esi ates cide as Pata ncaies Hclecees
Her Birthplace ....... OL. he RR ieRepeen. WOR ce “ahepi rps oe Charges.....eeeeee ee fee
£ emova RUE OR een. Sas 26 ei x eos Pic) Messing win car ae . Pees, ee
Body: to: be Shipped t0 sais cied vse. oie dle rete ore Sone tustenr Saas Tituaratioues.cccccs riots, hv Ga deere
SE NOD, eo Sn Estate. ogc aialcte sactbaetve’ a 5 fi 2 Soe Personal ServaGes i.. «Pei ee tuscee Hee wipe lle rerdes Sl eeaceice
Size and Style of Casket or Coffin..]. >. Cele wd. Ld"). SIOTATS reli: tes cnaraenam ts irs ees. tes ciakel bractncrary. susie. ela
st 4 \ Church Charges, $..... Ministery Sz).. cs olla es cunuacd ees
re = i a Smecsbaro tery 4 Fass pease eee Ck Eee ae Cee S « istedeemmend Taleghone Chavgesia. 0c. 0s.4 he
Manufactured by oom ae aN ine OR poicly a ieae's haarig ace Pal) BEAKEY SOLVICE 5. csih-s ao bine oe sie we wean Biel es tne
Intermiont at . . Gx AAchaai Carts: sc cietes. ABN ail SSC CCID . Oa Fo
Tate UNI eae, seiairaes ees MA occami lanl cia ga eee Go oe eg Ntlecs «ld cc slmalg waren Pr Realginealare aia ogee U2.
. CoE ea we ei re ey Total Footing of Bill.......0.00e0000es $. Pde
By A t Paid in Advance.......0055 £2-3.. 9.
Section No.....-;-+++yf Apsaunt Fals de ony poe $ # ack. oe
BBN rated ele rats bin passed, he Gee eae
ee thot ep Vault 0 TTT TEETER ERD Eee ee
ce Entered into Ledger, page....... or below]].....
a retusa ier To Funeral Charges...Total, $]..... bar exces Dies By i@agh: coo. 6.0 sew on tee oy Pils veoness
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