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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

a
RECORD
“Yearly No. £4 as es
Name of Deceased. .
Husband--Wife---Widow be,
Son---Daughter of
Charge to. KK. .
>
Casket or Coffin. .
[Matalin LADEN gic oo adic eraxk gh fo alee nge ton ot 6 +40 [semen
Address ..f 8 istike Bina)
Order Given by. .< KVGtSTAR “ROK ihe hen alors siccs wis eo > Seis s Hs ae offing tiene :
(State Kind)
How Secured Grave! Vallby Los scds Hides «bien Rese oeehene «tim 0-4 apeue 0(el[ ane sees sara
(State Kind)
Date of Funeral.. ]. Burial Suit or Dress.....0002 eee eee eee ea fereee eee eee
Residence ... +. /JA 0.. Burial Slippers and Hose.......0-ee eee elfetereee Bid a6
iE! a ol brit 2 ; . Engraving Plate....++.+.-+sseteeeserees alexa gesiys wvigs
, ; : Embalming Body (with elwe sg sie Faicleateras Fluid) . }....Funeral Services at.. Wirtatz-t. sess e eee ener eee Dressing Body, $..... Shaving, $.....]}...25Time of Funeral Service. .-.A.3.0.F. WE ener e eens Hair Dressing......-Bo ialSve canst dig Aes ee ede aes we
Clergyman . J 5 Use of Folding Chairs.. ..:..0 cece eee cee eel eeeeee eee 5) ae
. *¢ 46 Gandelabrum) $.... Candles, $.... )sse-ces5+ he
Certifying Physic soo : Door Badge, $.....Gloves; 6. 5 ious .sacot. is es ensiens
His Residence.. S. a. Aes aa Be eta cace: (ane sb tone . . enrne 2) tc accncts Sai 6 Ware t dipsee ow chins 4 Gils oleate » of[so eacgeak
Number of Burial Certificate....6.) 0-0-0200 + ges stare Auto Limousines to Cemetery. .@ $..----+--++. /errreere ta
Autos to R. R. Station..... Gr S.k, ube dello e 9 esac? Ly:
Cause of Death. ttnasnea. ee Rag ral be
i (Primary) tuascadhcy; Other Vehicle Service a pis FR Lig a Urauets 4 . Brite es
Date of Death.. N. ne ae ee Aeroplane Service me fein cinema Glaceua plaid vlaoor wate ee S. Geode
Death Notices in..... Newspapers....-. J-<+++e++
Occupation of the Deceased. Ss Fanaa Me agit aN A ceasn cn ail cote MI OMELL eo ictainiy slgeie > itee-¢eigae wh se . . eer
(Names of Newspapers)
Single or Married. S ten gligton, ».5.50044546>. “+++! Blowers, $....-Rental of Plants, $.....]]....Date of Birth.. saw. AB.: Of FA Mey lh daa wales Other Decorations. 60.6.2 sic be eee cele s oo sle cool eoaie, sen srs
Age..K@.. Years. 7 Waals abe Months. . /f'+...Days Outley tor Lot.. AO KAD. rer reereree eee 49,22
, ee pt ‘ Opening Grave or © Vault, Seen ee eee neee rs pe retotaretats . 8M sates
Name of Father. 1 FB ORAS os nis es ee es tee . Lining Grave with Evergreen or Muslin..... . ....
His Birthplace... <7. 7AhafY APA eee Matting, $.02).5< +.» . Tent Rental, @...-.0e-isc..
Name of Mother 4 fh t. er. 2 Lf lamer Use of Lowering Devitt.. 25 <6 sces wes os eal. cee
(Maiden Name) “4. Poastaliot Viatakts acct See neler eh Oo srcaltvin ot nls emp emer
Her Birthplace . Cn. 4 . peer . tang AER elt Outlay for Shipping Charges. ....+-.+++++++-eeeccee [eee
RemuvalCnarvesicc .aiso aor nes cats oo ge ene ores Natsu
Body to be Shipped to..f..----eee eee e eect reece EN RT ee rere crane nn eam
F esr us Bust 'anaveltibe: ¥ 0 kerala Wk wai nke wi sin aiaeste hele aididtols tis seins gee ono PersORBl SOPVICER ooo cce a n.6 > eens aie 8 9 5 Sie ss a 600 oll awed
Size and Style of Casket or Soma 4 1%. Wa BALAS... Se i es ae eer reer Games,
Church Charges, $....+.Minister, Ga <6 dell.. dualrreeent
S dere. frvern « “ Toney t Mella Wesicleice ene § Telegrams and Telephone Charges.....0.++.l[..sc005. «ots
Manufactured by.. tbs.. Ge. At. Aen. Pall Bearer Service....--.eeceeceeeeeeeoeel cceeee
Interment at (oe. Bp SO oe Are ee Cemetery) -20t3 ees eee + nite otic one e ote weigic « tieiaig et oe ime LOR Shy aon wipe . e: titag
Lot Weis 5 reer ee eesti «rare RSI Salieyy © 5s Soars alin orn <ilantas ak elini? wisp sie oF e's 9 Lehge: 2 M8ye lt oille-yuatale ate x AN
ee alt oe ee Total Footing of Bill.......0.+.2e0eeees $3.4. . Oe
By A tPaid Gn Advance «66. F805 ed 2k dies 1 BU een cies see
Section Nom.-.gi apse > ex » 7 Aenea, Feeds Revere $
Palanee ..6 chine cd 6 eke o-eeis Aes pals
weg Entered into Ledger, page......-or below]. .... 7 eee
Beineree ee 9 ore To Funeral Charges...Total, $]..... Se La pecs ABN Goo nse A tue gt ee Slegaie ew Peete