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Home My WebLink AboutFuneral Register 1919-1921 Microfilmed by fs North Carolina Bepartment of Archives and History Division of Archives and Manuscripts Raleigh, North Carolina onan . : . ~~: Rees . nl si = P .* . we ~ Ps . | ; e a ww y s Es wy A pa * ae Lae dS , “ D OD Cs " Bry Os nn bi rf e cd ’ S ag a ' + ee . Ps , P . bad - A % - « ed Ye ry 5 x * ey ; co . e Y ° s ‘ p nt ‘. oe e ” s i ° « ee oe | aS « 3 f Arenas — ee eee RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF ete. Aliy Ber her eat 2 & oa Residence Place of Deat! ah LA —_— Date of Birth , Y eee See (Moatb) Date of Death Yi cf " 4 Month) Maiden Name ss Birth-place Kt Ll Rtr GS Name of Father /d<. 1 “yf Maiden Name of Mother...../ LOCRLEK A te 7 Her Birth-place Cause of Death—Primary Ye, me Certifying Physician 4 - 1 eis a cad Place of Burial i /\_2 7 Tk Co Ch err Ch Cemetery * i 3a’. Wife or Widow of 16 3§ rs Years Sex Tota/ to date ee, Color or Race (Day) (Year) ee 19/9. Age Months 4 Single Lokhee (Day ( Year) ALC. Occupation Secondary Residence [eo Days Married /“~: ‘ yo Cy 448 ) ~ a Mic at His Birth-place Ka fe Chee Co A c : ha £4, QL Co x € Funeral Service at : i a f Lot No. | Put in the Diagram one mark like this Time of Service - / ee 4 te i f /G Crave No 1 | for every Grave in it. And mark this 2 f iy 7 / 4 Burial with double dagger thus : f Date of Interment Wire, of ELLY Section | iiihaeiadis ahi aiimmaiinanlli cl v / ; s : Casket or Coffin No. ? bY O Candles | Size Made by Gloves | Lining and lillow Set No.... Bearers or Porters | Handles | Hearse to LLL € rh ce hat ices a f O\@ C Plate | Removal | Outside Box or Vault Coaches | Burial Suit i (€ le Slippers I | Newspape r Notices Embalming | | Washing and Dressing | | | i} Shaving | | Services | Use of Chairs | lransportation Charges | j poe : Church Charges I | Officiating Clergyman Cor Ae Isa hart BS is Cemetery Charges i Amount of Bill ) een Music | | | Goods Ordered by J VS Qihles . Flowers } Bill Charged to Ki echen. a La at buh, Ae AYO ¢ poke Y1¢ aa aa ec “ / /) q 3 DR. feuku. Atrval Cet | a | | iH] | | | j 1 | | | tr A a Ar ioo \ —— | } ISSUED BY DOANTEE CASKET CO, BOSTON, MASS, 1818 _ a] Le i RECORD AND BILL OF !TEMS FOR THE FUNERAL OF Tota/ to date Yearly No. “+ Cilla. Nafar } Heaidence MA 4 tho ~< nr ‘ @ A : 4 a k j ; 7 Have of Death 7 MAA! Whine Wife or Widow of ® Date of Wirth od Y¥ 1? YeOve ah 4 19 4O Year Sen (444 AK a. log of Have Ate ithay) (Year) , wb Date of Death y 4 Zi 1/7 Monthe «© Single * iW Mus fies (Vder) Maiden Naru | Daye Married Hirth place QL Lap mar d ta (C a A & Oveupation ' vane of Rather . ces ed 4 Ave 7 Hie Hirth place Vo @h. (leke SC . Her Birth place RRA yo mr ssdas e | v c Lh Chav her re Maiden Name of Mother tthe OAleoe Qa Canee of Death TPrimnary 15 Ah dy & « i, « lwuites Secondary Certifying Physician AV \ ao A & Mn t QLanw | Barth Cemetery Lat Ne Ke sidenes hac ‘ of Har ial Vit in the Diagram one mark like tiie Funeral Servier at Pforeve y Grave in it And mark thie Time of Servier Grave No Date of Interment ji a im f /' f Severthevn ~ “as Designate aite of menument thie C) Cteneninnninenetneeen . - enue ee ccaeatieneiniilasiias siemens saiadiiaiia nae Casket or Coflin Ne path Candles Hiial with dewble dagger thies 4 i Size Male bry (loves | | | Lining and Pillow Set No | Hearere on Portere | i} Handles Hearan te ] | i| Vlate Kemoval | ] Ohsteide Hox or Vault | Coaches \| Hasvial Suit | } | Slippers | Ne waprapr ' Notice ea Panbaloving Waaehing ancl Dremorny Shas oete Servier Uae of Chan Pranaportation Charges Chitreh Charge OMfeiating ¢ leryman Amountof Hill Cemetery Charpe Munir Coole Orclered bey Pliawe ta Will Charped to CR TTT Aten eee et tetera etatintinttensemttly Dr | | | r be 4. | (tle 2 Aw CRiedas A, Hod how » Kann eo] fp BOt. NOW Lam | i rseseenseneiseensssneessisdinesssniesnesnnsttenssseessiiennetnnsm POU EH BY HORMIEE CARROT OO BhetON Mabe fete RECORD AND BILL OF ITEMS Yearly No, a FOR THE FUNERAL oF Tota/ to date ‘Cea, Ie / es $y / Kee eK: bho (000 Mhirce \Naekie yg og Heetdenoe wat ang wd { Masd 7 e@. ’ Place of Death ‘+ t vs Wile or Widow of . 7 ; 3 “ } Date of ieth a f Piaf ~ Py of | gk d/ " +f Veare Sew €4.4.4,.4. * Color or Race (Month) (Dar) (Veer) j Date of Death rt “R Vv oy \pe Monthe 4 Single Sad ° Heh ‘ Movsth ) (May) sae) Maiden Native , | Daye Married 0 : {¢ Hirth place Ca (abo, —e } . & On qupation Name of Father M my: “ He Af Age Cee’H ic Hirth plas e és hw ® A © y¥ afer See ta, - - <> . Maiden Name of Mother cd Ce Hor Hirth place ¢ A Ja t\fhan a A é Cause of Death Primary f Secondary q (fp ‘ ag Certifying Physician al 2 a4 “" Residence (a ha ¢a/ ha r i (2 ) ‘ (/ 4 Lo Place of Burial ¢ ¢) ki Ate) he Roh aww OF, Cemetery . as ‘ ‘ . ae »¢ j buneral Services at / l &4 & Lot No Put in the Diagram one mark lhe thie P fur every Crave tit Atel mark thee ferave No | ‘ Se ’ WAG OF COrvice Huriel with double dagger thiue) f ar ( { ’ Hate of Thterment Pa ‘ ” u J / / Seotion ] pel Designate eite of monuenent thie 7 4 —— wet ne i ws Casket of = No ue v cis A J Fase U (ers (andl | roy | ive \ Maule by ‘ ( t« Ow (oloves i | Ota and Wil Se Nu, ( ‘ ‘ ‘ f" j Ihe nrere oe MITE ' ‘ } Handles ) LUCA. Mar Hearn to ORs wf /@\o o V hate i Heanoval | i | } Outeide Hox or Vault Y i| ( oachea | j | arial Suvit / } q € | /1\oe | ippere Ne Wapapiet Nistieen Pornbalin tig i 4 PO || Waehing and Dreasing | | having | | i| | wevines i| 1} | tee of Chaire i| Pranapeort stion Charges v) a fe : Chrarels € hares | OMieiating Cterpynnan hed Abs, Wy ROWE ae il | j Cemetery Charges I | | Atmounteot Hill / 3 (/\i¢o ~ Music | Caos Ordered bé ) (fh Prawn RPRare i} | ‘ blowers all © dee ange tl te , Le re laud i A MERE O SE Recnicses. sy OE ~: Fat ana Dr Cr al, Wy WA eby (yg Mar “hoe | p 4 Lah Ly Cen 4 l dt | / A Aha ff lo 0 i ' cy } I Cos tas gf { 4a pO | \| / | “| 1} oe "ue ) | | ] | | i | | | | F | | | | 1 j j | | | | | | | | | | i = ia | | - | 190UGO OY HORNTRE COOHET OO Beeten Mage. tote were R FMS YT sa inner ice tate asec — FOR THE FUNERAL OF hd a laine fale, Yearly No. 7 a : a RR... | aia’ Residence S j Jre rel Place of Death®@22 yp (trad vy (AAA Wife or Widow of 4 Date of Birth fh y° Op sit 4q Y &_- Com f “ J / Memth) (Day) (Your A , ¥ IG o Date of Death Maiden Name Days Birth place Occupation Years Sex Months § Single RECORD AND BILL OF ITEMS PMA = ad . Married ° Tota/ to date Color or Race kKuto- “ Nan of Father His Birth-place , Maiden Name of Mother Her Birth-place vise of Death = Primary Pe “ Secondary ) : : ‘a | Certifying Physician c X SK ate oe Re AoW eowiheornec'e Ket (a lew v Ran a & | Place of Burial CMa Ae ~ oF ae We Cemetery sa { Funeral Service at Tot No | Put in the Diagram one mark like this Tine of Servi Grave Ne Cn se Date of Interment Section | Designate site of monument thus: eo ; eso ! Casket or Coflin No 12 he e/ : Ko y Jv. 00 Candles } | Size ( Made by Gloves i Lining and Pillow Set No Bearers or Porters | Hearse to Handles | | Plate j Removal | Outside Box or Vault Coaches | ) | —— kines Caen 44 MV oO Burial Suit Slippers | Newspaper Notices be "| WT po Embalming . p ‘ Washing and Dressing Shaving Services Use of Chater Transportation Charges Kerrevel Woes! robe Hen Sea | Cemetery hharpe Church Charges Ofhieiating Clergyman Amount of Bill Goods Ordered by Music Hill Charged to Flowers | f | KLW Qk ype he f- j meometnnennternnenry gem ma oo pt te gall, Ap. £2 yr /) ] Ad j a [ | Fa j C , oD je YO Qa. £ brace | vil? | W420 4, h ( eg ae caeegum I a9 | j ee oe 1SOUEO BY OOANTER CAGKET CO BOSTON Maee tore Yearly No. Residence Place of Deat! Date of Birth Date of Death Maiden Name Birth plac a Name of Father “ Maiden Name of Mother me Cause of Death U gis Certifying Physician My A : Place of Burial Funeral Service at lime of Service Date of Interment Jot, RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date 4 Ova A Whe, Reedy Yaliat hed! - + / (Ae Wife or Widow of OCL J lof | Years [Sex (“€eenete Color or Race nb,” fe ae 0/9 Ane 4 4 Months Single “vue Cibteatey ~ 5 Days Married IV hege (% d hE Onc upation } St ahs datum y His Birth-place f? Ve RE &% CL N<chte & roe ACH had Lg, Her Birth-place ity, Residence Primary S. MeL Rassy Cemetery . W Tot No | Put in the Diagram one mark like this *y : | for every Grave init, And mark thes / / Grave No Burial with double dagger thus: f i / [i Se i 7 ection | Designate site of monument thue ate : iz si = p ; Size LN Made by “ - ©! Gloves ] Lining and Willow Set No | | Bearers or Porters i | f Handles | Pe (eA thhagey 4. Pe Plate | Kemoval | Outside Box or Vault Surial Suit Slippers lonbalniing Washing and Dressing Shaving Services Une of Chairs Church Charges Cemetery Charges Munie blowers DR heh Uf / © Jo Ceut Coaches 1 | | Newspaper Notices | Pransportation Charges ) j ) O,/ | Ofhemting Clergyman ARM Ng Ca vhct¢ | sliciii Amountof Bill j | Goods Ordered by & , ' Hi } ; | | bt: Mebe . Hill Charged to, / < a a to herve 45 bo JG My Ca. ah_ | Vere | Sa ed a 4 i ‘4 | ie 0) | : i i | I, | FS ae | | | Po | | | | | i i} | | | i | | + pee | | 19ONEO BY HORNTEE CASKET CO B0G8TON waee, 1018 1 cuneate RRRRNNSINt ti Time of Service see Yoarly Wo. \{* Residence 30% Conor Place of Death £ Date of Birth 2% Date of Death Maiden Name Birth-place gl eae A | Name of Father” patent Day Certifying Physician “7 YW, 1 ORs Other CoP 45. CELG- Maiden Name of Mother Cause of Death Primary Place of Burial C aie Le 2S plone Funeral Service at = o / \ Date of Interment [ Mgath) (Day) 1} (Month iP (Dey Caz iran? hPa ee ee RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Wife or Widow of 7- G Years is. (Year) 19/9 Age s (@ Days Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Tota/ to date b (eee Colorer Race Months Las aK to— Married LF Paste te ee. Steinar RKO 5A Ce. Lot No. Grave No. Section Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate site of monument thus: C] ) aseneunsnnemenetstssuensipmnnanmensoutmanssacsssasae pnmanen _ : a Casket or Coffin No / 7S |.OO! Candles } Size Made by || Gloves Lining and Pillow Set No | Bearers or Porters Handles || Hearse to Plate Removal | | T Outside Box or Vault G oac thes Co29 Tinsel Sanrg Sa cary 8 | oD Burial Suit hag NA? 7 fon | S 100 | Slippers Newspaper Notices | | -— | | | Embalming 2. <> oo | Washing and Dressing Shaving | services y p Use of Chairs pannst SS © CHArL) 4 So Transportation Charges Church Charges Officiating Clergyman “Ree k- ~ ral) , oC fee = A\ > Cemetery Charges geet Fee, |O 0) Amount of Bill | 2 1 gj } < ’ | iE we | Music | Goods Ordered by MY &. 5 YO = Flowers Bill Charged to Ce + r. g c bef — | DR CR. { | | | aeckal '@OUEO BY DORNTER CAsKET Co BOSTON, MABE. 118 suemennsesnenemniltt RECORD AND BILL OF ITEMS Yearly No. Residence Place of Deat), , mn & Date of Birth 4 (Day Date of Death Maiden Name a ee Birth-place Cause of Death Place of Burial Funeral Service at Time of Service Date of Interment ——- ee Name of Father —— wD pt Maiden Name of Méther cause 2 Primary Secondary Certifying Physician >a ake aoe Residence any be deriahe / A ' © we st ale ert - | FOR THE FUNERAL OF ¢- W ife or-tiesonmet~ 597 Z2Z- Years f Sex Fire 2o (Year) 19/9 ze 3 Months ¢ Days / Occupation His Birth-place Her Birth-place san HEkearthp, W ’ c : wiles Keren e. wired tg Tota/ to date “3.8 « A. &. oe | Single | Married Cemetery Lot No. | Grave No ‘ Section 1 for every Grave in 7. Color yf Race Put in the Diagram one mark like this it. And mark this Burial with double dagger thus: ¢ Designate site of monument thus Cc) Casket or Coffin No. Size Made by | Lining and Vlillow Set No.. Handles . | Plate Outside-Beaser Vault | Burial Suite Arog- 2 } Slippers ikimbalming Washing and Dressing | Shaving | Services Use of Chairs i Church Charges Cemetery Charges Music Flowers | A © © © ©. Candles Gloves Bearers or Porters Kemoval / 0 © |OO! Coaches ~3S |eco New Spay T Noti« Cs aS |e o| | i I} a Transportation Charges | Officiating Clergyman Amount of Bill Goods Ordered by ‘ | Bill Charged to Hearse to ' J . “ {ern 9t>+rApe | | dmad Wutts DR. 7 7 bp awd, Bs 20 “| i | | | | . | | “ | j | | | | —J | | | | | |_| | | ee ae 18CUEO BY DORNTER CASKET CO, BOSTON. MABS.. 1818 ene tee een a = RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date. 2) flere su— Gob~ik ‘olor or Race ASK aQpe Yearly No. & Residence Wife -eseellltetery Of Date of Birth 29 Years Sex te-ancen See I Deatl 2 LF : 19/9 4©_ Months 4 Singl Yate of Death f Age onths 9 Single Maiden Name tA ? aE. ; ) sei : AB Days sa / Soe Birth-place pe mtornranY te “A. © ~ Occupation UPSCL Name of Father ; s I's Birth-place es e 4 Maiden Name of Mother i Bien S Co) Satea. 006, Wn. — eG ae Gta, Put in the Stabe one mark like this | for every Grave in it. And mark this Place of Death wbcie , Nn. € = Fees, beg er Birth-place 2. 3 Se Secondary Certifying Physician : TN Residence Place of Burial Haokeaww2e , PN Aci Cemetery Hons Lot No. Cause of Death — Primary Funeral Service at Time of Service Grave No. Burial with double dagger thus : ¢ Date of Interment — / 4) / 14. Section Designate site of monument thus: CJ | ~~ en ali heer aed ” -- : a Casket or Coffin No 7S ©: Candles } Size Made by } | || Gloves Lining and Pillow Set No. | Bearers or Porters Handles | Hearse to Plate Removal Outside Box or Vault Coaches Burial Sait yee 1 Q\e0 Slippers Newspaper Notices Embalming DS] 2.0 Washing and Dressing Shaving | | Use of Chairs Transportation Charges Church Charges Officiating Clergyman aie Cemetery Charges } | Amount of Bill 1/ © oo. Music | Goods Ordered by fe A Dan Flowers | Bill Charged to Be wen eae | CR. ane ALTOS ile 14 ie Mente. (hay 2 Li im Aheue > hijo fiahsl hay | /S_\_ Veo Quut Coe er | He 6 ° | (p,\8 v | | rr oe 19OUEO BY DOFPNTER CASKET CO, BOSTON, MAGE. 1018 RECOR An Mur ha. sable hte hte Place of Death: Date of Birth Yearly No. (Day) Date of Death (Day) Maiden Name Birth-place rt & Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physici ae NWO offi Place of Burial Funeral Service at Time of Service 7 (Raw Date of Interment phy VO // ¢ 72 | Wifgor Widow of ls KH: Ti 16 §¢ b D AND BILL OF ITEMS [Sovtilag “Presi OF Total to date T: Le g Years { Sex St Atal _— To [ Color or Race 19 1949 Ave Months Single . ear) : ge | r. ST Days \ Married Gi . Occupation ~~ His Birth-place Her Birth-place Nngavta. ~@. LxC. Secondary Residence Cemetery | for every Grave in it. And mark this Burial with double dagger thus : ¢ ee oo Designate site of monument thus: e" “GR. “C ¢ € Oh Ch- Lot No. | Put in the Diagram one mark like this Grave No. Section asnsieannsicnet nicest ey re: oat fessn Casket or © Size ginny by Lining and Pillow Set No.... Handles Plate L Outside Box or Vault A7y ay Oo o4- Burial Suit Slippers Embalming Washing and Dressing Shaving .. Services l'se of Chairs Church Charges Cemetery Charges ; LPL o Music.. a race ‘Cte Lecter By I 50 Oo | Gloves Gro- Mme 2 Candles || Bearers or Porters 5 cg | Hearse to lina ele CO | Removal 1) te OL pre i pie JO) Coaches [is fave Axi i 00 LQG Newspaper Notices 4G) o | Transportation Charges \| Officiating Clergyman ‘ 0 2 | Amount of Bill (. 4) , vic *.. Goods Ordered by Corvcbe | | 1 | | ” ; | | Bill harged to N Q Gy) 8 Q Flowers DR. CR 4k rola Jo Qeeep Ale | q vivo) fie 5 Js So eZ | Kuve Rial | | / | bord oso | Ll = i | = as e | im pl | | | Pe | | “| | ae ed ; | | od | ee | oo | me | om } | ; | 4 | = Hee Wea nee a | | | sige | : . — | | Sara, —-—— a | ice aaie iii iil 2 | iiilani intlietinacnisaal cscs rs — —|— _ seliabihiiedigagasniilial | | ~ ISSUED BY CORNTEE CASKET CO... BOSTON, MAGE.. tote Yearly No. Q Fat “fife, ‘< Residence Place of Death ALM gy che x €. Date of Birth jt ue oghb, (Dey) LAbeths> Co AES Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Primary A ‘ é AA Le ae Abe ; : a Certifying Physician /- ot ee... Place of Burial i fa th. Core LM» usbro Funeral Service at Time of Service Date of Interment iikda or Coflin ri Spe ee fhe Sf ... Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing pen cag ro halla Shaving Services Use of Chair: Church Charges Cemetery Charges Music Flowers DR. ~ , , ; fe wu /1G JO @emnk lee 20 | | | ! 1 ' HEE Wife or Widow of 19 q (Year) 19/ = Occupation His Birth-place nag “ther Bi Birth-place Ott... Secondary RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date a ak te Years S Color or Race Months 4 Single La g : eh Days Married/A mreceer’ ; Re aca Carel Ke, G. 2e_ Residence La te pedis AC WC Cemetery Lot No. Grave No. Section Z atin Geo 2. © || Candles Gloves Hearse to Removal Coaches so Siac Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered DY I JM: Fae’ Bill Charged to Pec, Yb ahs | ee = eres Bearers or Porters Newspaper Notices Put in the Diagram one mark like this I for every Grave in it. And mark this Burial with double dagger thus : f Designate site of monument thus: CJ «efit | 1SOUEO BY CORNTER CASKET CO. BOSTON, Mass. 1918 aa RECORD AND BILL OF ITEMS // Yearly No. Kaiji Lt 2 AC vrRhr Residence Place of Deat!: FOR THE FUNERAL OF Ghurot Berl Mitt thank Le ARAL. fe or Widow of nanellinasaiiiil Tota/ to date / : Color or Race Date of Birth 19 | / Years (Mont (Day) (Year | Lim, he Date of Death f 4 27 19/F. Ages JS Months 4 Single CO-#K2aLe Month) Day) (Year) | Maiden Name i Days _ Married Birth-place Occupation Name of Father His Birth-place Maidea Name of Mother . Her Birth-place +f ’ Cause of Death— Primary S te ty Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this rm ra : . ; ' for every Grave in it. And mark this > of Service Grave i ) Time o " rave No 4 Burial with double dagger thus : f Date of Interment Cinet | ite of Interme ection | [ Designate site of monument thus: a | " eer se 1] Casket or Coffin No. Candles | | Size Made by Gloves | Lining and Pillow Set No... Rennie or Porinrs a Handles Hearse to Coe ee far se Qfrc fad /O\0 © Plate Removal "i | Outside Box or Vault i Coaches 1 Burial Suit | Slippers t Newspaper Notices | - ; || | } Embalming | i | | | Washing and Dressing | Shaving o “ | | Zz | Seiahach Atbad angen Poet fam oF k? O || ; | | Use of Chairs Ae kes y ; é lransportation Charges Church Charges Officiating Clergyman bes | | er _ Cemetery Charges i} JVC Amountof Bill / 81020 : i | | ~—<—Z 3 Music } Goods Ordered by ALS TT £404) | } og Flowers Bill Charged to fi CL A Kae saHl- DR. CR. + sss a rast es - my 3 PY | rk iL, WY) KC / wee (1b, J _|~O Qewk Lece SIO) frie hy Lt pS MR tt (a4 je * 1 | | {| | -{ | | | \| i) | | | ~ - {| | | - i| i e | | | | \| | ~ | 1 | 1| | |! ! } | | si ij | | j {| . oe gay I Bran | coca ' a ro | i aca ore ” - | | | | ne aie _ oN | ic --| scenester i | — cm t esiuins j ‘a | | ee ee a a Be _| sia — dt Peer ere meee i- nnn ene | } | | 18S8UEBO BY DORNTER CASKET CO, BOSTON, wAS®., nse —y eee ee initiate Yearly No. { R Residence Place of Death Date of Birth Micke Date of Death MMe path ) Maiden Name Birth-place Name of Father Lé g 1. ] Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial itt Funeral Service at Time of Service aa A 4 Puede Sorficr- Ker pce FOR THE FUNERAL OF Wed. J. bowwew— Rap Viel Mey 2 19 of / Years Sex WML yy (Year) 73 1979. Age ‘> Months Single (Day) (Year) s : oi Days Married kc Xe ME te. dy J gif. Keegy, C b uy eh AL. Wife or Widow of Occupation His Birth-place OC. Fanti ha Her Birth-place ce Secondary Residence Cemetery Lot No. Grave No. cf} RECORD AND BILL OF ITEMS Tota/ to date. Color or Race DHL > Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Date of Interment P< of 7 Secti ee é fe ‘i Designate site of monument thus: CJ oe | T Casket or Coffin No. rr [Llar- /V ©...) Candles Size Made by | Gloves Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. 1S8UEO BY DORNTER CASKET CO. BOSTON, MAGS. 1416 Bearers or Porters Hearse to Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Mares 2 lee Amount of Bill Goods Ordered by 7 os Bill Charged to " Sf yQRinsn Os Agen oe eon nen RECORD AND BILL OF ITEMS FOR it 2 Residence. fre k Place of Deat!: Yearly No. YF Date of Birth - Aptis 19 19 f Years Sex Color or Race (Day) (Year) Date of Death _ ni of 7 wa ae .. jae Months 4 Single Maiden Name ‘ Days | Married y Birth-place Occupation Name of Father E oe SR Maiden Name of Mother nh (Atr be ee Cause of Death—Primar dy Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment 4/19 THE FUNERAL OF Mav acme f~ R$ Wife or a Total to date~ bx: His Birth-place Wudece @ “A Q_ ‘x Birth-place Srehore. @ Ao Secondary _ Residence L2-v Ww 2 Cemetery festa KO Lot No. ( | Grave No. J Section | 7. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : f Designate site of monument thus: Cl) - Casket or Coffin No. 200 Candles Size Made by | | Gloves | Lining and Pillow Set No... | || Bearers or Porters Handles Hearse to | Plate } Removal Outside Box or Vault } Coaches | Burial Suit | i Slippers | | Newspaper Notices Embalming | | {| Washing and Dressing Shaving i | Services | | Use of Chairs I | Transportation Charges Church Charges | | Officiating Clergyman eae Cemetery Charges } Amount of Bill aaa ee Music | | Cectie aden ty Ae fhorra| Flowers | | in Charged to DR. CR. J. = aathcaby A. le coDa Paws) elaa Ae7, é, Gna | dee 7 Fe i tote | 4 » “| — 4 - “| a | : 1 | | | | i 8 oe | ne | see i . aa | | | : oe | | _| | a ee | | i 1 i i i i i ISSUED BY CORNTEE CASKET CO, BOSTON, MASS.. 1916 13 \ Yearly No. AY € Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place kL a Name of Father Maiden Name of Mother Diet le aun CL ett. sl ats “Th 44 SEE b4s aa cet. fu ¢ A Mon ies RECORD AND BILL OF ITEMS FOR THE FUNERAL OF SY Bede ( joc) rp : Gat 7 Wife, or idow *s _ to HG ts, Ta Years a > (Day) (Year 19 j ath (Day) ie - Mont hs Single oc ue oe Married GLL © A ¢ Occupation . —~B~<r~ 2+ os x acs fe « -_aee~ His Birth-place Jo vObA v py @_£e 44 Her Birth-place ya Ce (2 Tota/ to date — Atal Col or Race jille_2f = "AL RECORD AND BILL OF ITEMS @.,, No. 7 Residence > O31 Place of Deat! — AG (Day) Date of Birth Date of Death Maiden Name Birth-place AGjrhord ; A < Name of Father VAAN Cong Maiden Name of Mother. ONAN 7H Cause of Death— Primary Ea 2 FOR T a fF A ko Certifying Physician hdr. Pat Dia ti Cause of Death— Prime A te Secondary ) : r c 1 Certifying Physician C sae Residence Shle wollen A C_ f’ : 4 Place of Burial Ce iy A Ci Cemetery Funeral Service i fe Time of Service 7 Vag f ae f= Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t a> Por i 2 Het No. 4]h Grave No. Date of Interment yi: e / .. Section ; Designate site of monument thus: ibe i AE OIE ea nett Soe For ane ‘ si L anaes i : I! | Casket or Coffin No C © ¢ A Candles | | Size Made by | Gloves Lining and Pillow Set No I Bearers or Porters | eae C€ Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Hearse to .... Removal Coaches Oc Newspaper Notices AG\EC | | | services | Use of Chairs Transportation Charges | Church Charges Officiating Clergyman | Cemetery Charges Amount of Bill s 1 7 _ oo Music Goods Ordered by Ge ce TF, es a ~~ ’ i Flowers Bill Charged to 7 Kae Se Oat etm DR. CR. A : — — — — ne | 2. Jo Lete ls ee; va ¢- 2500 ~H sa | i] > a Es I 7S C¢ JO\SO ‘ t “) ¢ ~ | —{- -| is | } | | | ' | | | | } = | | sae led - } ay | | | | since ved | | \ | | {| teen is Ao " i 1 1SBUEO BY OORNTEE CASKET CO. BOSTON, MASS. 1018 Place of Burial Funeral Service at Men tha AA a: © FUNERAL OF Tota/ te date. oS .. Wife or Widow of x A a S tl, (F& ¥ Years Sex fh... wl \ge f 0 Months ¢ Single : 7 | — L Married We AL cat Occupation 7 OF ia ois -< f Ate Ab ) His Birth-place Her Birth-place Secondary ; Residence Wf Ca (tut l ( Cemetery Lot No. Grave No | Colof or A ne iv 1 for every Grave in it. a 4d Race Put in the Diagram one mark like this And mark this Time of Service } Burial with double dagger thus : f Date of Interment Section Dhidieaie ida el naiaiaia lak ry Ee “yy m — ee ' | Casket or Coffin No. : Y O16) Contin } . i Size L ay Made by ., 4 wile } Gloves I i} Lining and Pillow Set No... Bearers o1 Porters os | - Handles Hearse to 2 , al~o— | 3 = Plate i Removal } : | Outside Box or Vault i | Coaches Biacial Sale Lbrcar | IF O \ee | urial S i] Slippers Newspaper Notices 1} St ~I| OC ' iEmbalming i 5 | | i] | | Washing and Dressing i | . 2 I} j | Shaving i | Services | lj | Use of Chairs | | Transportation Charges Church Charges | Officiating Clergyman Pee j | } Cemetery Charges ] Amount of Bill . | Oo oO Music.. | Goods Ordered by a ‘ o- <L {| | oY ?, Flowers I Bill ¢ harged to lA WME *y Ly sesh dane “al H ” io Pate DR. CR. ees cece — 7 57 . , e ) 7 [7 FE, i ys aA linseas tof Kets Vea oT |? Co hie _ ot a i“ eg (Ax CAR a7 LAPS | Ar P a i oF 4 oo — —— 1 oe _ oy ih _ —— - —| | 4 | a } ike \ | | oe oe 7 =| 4 i erent I - } } | | | | ase | i| II | ae | 7 i i| | | | a i | i | a, sanaisiasalccaniatiataeessoui Gai 1S6UEO GY DORNTEE CASKET CO. BOSTON, MASS... ete 15 a erent cape RECORD AND BILL OF ITEMS : : FOR THE FUNERAL OF C Ch Loa 6404 MEME cnn “Mr os Os FO —f¢ "4 oe Wife or Widow of i z A 19... ST Years Sex Tota/ to date. ae Yearly No. Residence Place of Death A Veo, ches. hov Date of Birth 7 Z Race Mopyh (Day) (Year Y Date of Death fr hfe J 0 19/9 Age s Months 4 Single Month, (Day) (Year) Maiden Name } : G @ bE / G Days Married dirtli-place (Ch a vs Occupation Mi faf VA oak OBS Mig Mi teins. Ce = ; Leg Ke he LO. Name of Father UL 2 iL Wa dArreekl Maiden Name of Mother SOr QA tere at Cause of Death Primary GA Myers Ahan Le: PS His Birth-place Her Birth-place Re fecondary Tr. Certifying a. — Residence Place of Burial 7“ WGQL Le AE : Cemetery Fune ervice i ineral Servi u Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this Grave No. . Burial with double dagger thus: ¢ C2 LAw f/f hy Section ; Time of Service Date of Interment Designate site of monument thus: . Casket or Coffin No (Ls oo Cerhiung on vee . Candles | | Size i pic, /0CC.e Gloves } Lining and Pillow Set No ae Bearers or Porters | Handles | Hearse to Plate Removal | Outside Box or Vault Coaches | Burial Suit / loo | V Kudinmsoce /|\VU \| | Slippers Newspaper Notices I] | Embalming V4.00 Washing and Dressing | Shaving } Services Use of Chair | Transportation Charges | Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music Goods Ordered by Cc k¥ Uhegcsen halle Flowers sill Charge a 5 e c : wel 2 : = Bill Charged to , for Calg DR. CR. XC, Jbyg. W Reeef of hee ; ose | 1SGUEO BY DORNTEE CASKET CO, BOSTON, Mase. 1918 ~_ = l (Ceeg) « 1 fo Lf he ce oe O RECORD AND BILL OF ITEMS re Tota/ to date Yearly No A 1 FOR THE FUNERAL OF y y ' f Ute, Mitwttni /Klit Chaciasr Residence J FAM v2 é ck os x Place of Death Hike orc a n a c Wife or Widow of Date of Birth “tht a 2 iv f A Years Sex (tees he Coler or Race Date of Death CORE “% om 1975 ie JS Months eon Oke Maiden Name . Aiea — { / Y Days Married Birth-place klinflirte —O A C Occupation wos _ ee ~ Name of Father of -/ Ker Ob pe R Mes His Birth-place A CAFC E_2 ie Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. | Put in the Diagram one mark like this Time of Service Grave No. rk poe cece this Jate >rme Section Date of Interment ectio oe oe Designate site of monument thus: cs | rd Candles OU ee_ 2 Casket or Coffin No. Size Made by ~T- z aY | Gloves | Lining and Pillow Set No......< Bearers or Porters | Handles CZ € ay ff Hearse to | Plate HM 4 ri A v | Removal | Outside Box or Vault . “- “Cb, / \| Coaches i Sai ‘a Cy , Burial Suit e hk . Chicas ‘v 4 Ax lippers 4 Fad I te | | oY ptr a | TT iii per ne Embalming.. (: U7 - Washing and Dressing ? caf | Shaving = a | Services ir | } Use of Chairs } | Transportation Charges Church Charges I | | Officiating Clergyman / Cemetery Charges i Amount of Bill | a (c GB) Qe | woh ff \ eo Music | | Goods Ordered by eh Chace Ban i | | | Bill Charged to Flowers DR. a SSRN | i | i | i 1} 1 | I | i| j {| i ie -| i} i } } } iy 1} i _ } | | j | | ' ‘ 1} 1 | i | i] HI | mil -| | i | | | | | a] 1SSUEO BY DORNTER CASKET CO, BOSTON, MABO.. tet] is | ies j 7 i al 17 sp aereaatem tenets se nen Yearly No. f g Residence Place of Death RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date r Jif f 7 4 Wife or Widow of Date of Birth 19 f Years Sex Color or Race Month (Day) (Year) Date of Death 19 Age Months 4 Single Month (Day) (Year) Maiden Name Days _ Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death Primary Secondary Certiiying Physician Residence Place of Burial Cemetery Funeral Service at J . eo Lot No. Put in the Diagram one mark like this isn ok Sarvicn Gack Na. | for every Grave in it. And mark this Burial with double dagger thus : ¢ Date of Interment Section Designate site of monument thus: [ ] naneesennanitiaaraiasnsinieenciaiaciemmiti seen 2 . Casket or Coflin No Candles | | Size Made by Gloves 11 w | Lining and Pillow Set No | Bearers or Porters | | . | Handles | Hearse to i] | || i Plate Removal || Outside Box or Vault Coaches | I Burial Suit i Slippers . | Newspaper Notices I | || k mbalming | | Washing and Dressipg | Shaving Services Use of Chair Transportation Charges | Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music Goods Ordered by da Flowers Bill Charged to ee eat cE a owe , a DR. CR Uh : | a oh pn Ni heeg?5f7 | KI CL. 2h 25/0 0 NG | Sip eh |S } a | | | | m | | | | - I i 1} i 1 | | ‘ | Ht | | | {| | | | | | queso <i} i | ec | he ual 2 aaa 7 | | | a = | licenidheminenentiind ‘ | ISSUED BY CORNTEE CASKET CO. BO8TON MASS. 1018 a ————my RECORD AND BILL OF ITEMS Gs Yearly No. FOR THE FUNERAL OF Tota/ to date CELA, A Rv C at Residence Place of Deat!i Wife or Widow of Date of Birth 19 [ Years Sex Color or Race Month (Day (Year) Date of Death 19 Noes Months 4 Single Month (Day) Year) | ] Maiden Name L Days | Married > 10 Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death —- Primary Secondary Certifying Physician Residence Place of Burial Cemetery ; i ; { Funeral Service at Lot No. Put in the Diagram one mark like this ote . : . r ' | for every Grave in it. And mark this Time of Service Grave No. d Burial with double dagger thus: t a j = > Sag ; Date of Interment Section | r Designate site of monument thus: Cc] Casket or Coffin No. /b-& ep 0 Ths Oy Le 7 O10“ Candles } i Size Made by Gloves i | Lining and Pillow Set No... Bearers or Porters | Handles . Hearse to | Plate Removal | Outside Box or Vault Coaches i ’ ate aq\7 ¢ Burial Suit 7 Nee riit Ker coreoy fj / | . Slippers | Newspaper Notices 1 | lj Embalming | Washing and Dressing iI j | i} \| Shaving | j i] | Services i] | | Use of Chairs Transportation Charges } Church Charges | Officiating Clergyman eo | j 4 o7 q Z Cemetery Charges | Amount of Bill AVE i] en Chie, Music | Pict Gibieed bs Cea Lat. | Flowers Bill Charged to DR. CR. . rf ee eee re fe ay ij / - : 00 i eeg yW//y, Vo /deee Yood 72. 7 fe Bitty Ak a6 be “| Piso I of Ze | | comment i ( i —+ ay - re yf AF fos \ Card I S$ | @Q os i | | / —| i , ~ } | — j 4 ij | || 1 | —~ \| | | ~ } | 1 i! | ais | -| |. i| | ii 1} j} j i - {| i] i } | i | | Hi - | 1] | | } { _ | | | | nd , i iicsadiietecicdaia | | i] ee | | | | | a bi | pines i ae | ; . | |-—|_— nile ‘ | j | _ a | NE cee —{| —— Hasse - a j | i _— i ISSUED GY DORNTER CAEKET CO. BOSTON, MASS., 1016 ) : OU ame 20 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Yearly No. BZ ? Ie, hak tg i a Residence Place of Death fie Che 424 A449 Date of Birth Month (Day Date of Death Month (Day) Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Primary Certifying Physician Place of Burial Funeral Service at J ime of Service FC14L J Af of ) ‘ ~ (Feira 4 hiaClicec.aar 19 (Year 19 J 2 y Wife or Widow of J Qer-2et (Year) Years Age Months § Single Days _ Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery 4 Sex “<<22 @ ke Lot No. Grave No. Tota/ to date -C 2 Roe Color or Race Kyi L Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Date of Interment Section sate ’ : as Designate site of monument thus: C] ¥ scninieanmmnmianinineaiaatninaeimninimeain te ial - ’ Casket or Coftin No. Candles || Size Made by Gloves I \| Lining and Pillow Set No Bearers or a 1s LZ. Zz || ~ = i e2eLle Oo Leee cts. i| / | Handles Hearse to ./4 “e Cleo PE gest UMReele | L\iSCc | Plate Removal | | 4. Za } ; Pm f\o Outside Box or Vault Coaches pay ah / ce i Burial Suit | | Slippers Newspaper Notices I | } i! | Embalming | I Washing and Dressing Shaving | I services , | . Use of Chairs Transportation Charges Church Charges } Officiating Clergyman = Cemetery Charges Amount of Bill 4 ae Sse Music Goods Ordered by \heche 4t Cltaare P Flowers Bill Charged to ie | a a mel | t DR. CR. 7 Fae ro I, é i| s bs CL « 2g V /G ° 7 c¢ f/rivc oet Y¥LG id, C4 oA__- | pe | i Eo + 'SOUEO BY CORNTER CASKET CO. BOSTON, MASS. 1016 21 RECORD AND BILL OF ITEMS Yearly No. 2 é eg : a : ; vA et C4 C/ UA Residence he MC Lise ch ky Place of Deat!: { ; - sia Date of Birth AM £0 tet Ata109™~ (Month) Day) go CL ¢ a (Moav ) Day Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother oe <4 “HYz2 (LO Cheug Adicr co AC NM eirr~ hy « (LLE_ Qi, « 4-f-~ fh 2 tte/~ CLLA (Year) 19/9 (Year FOR THE FUNERAL OF i ce r Wife or Widow of f A ~«<... Years Sex hale Age Months 4 Single | Days | Married Occupation His Birth-place i Bcif Aerated Her Birth-place Tota/ to date . Color or Race Cé ot ok > _LEA Cause of Death— Primary Secondary \ f ‘ a o Certifying Physician A Ct <f eect Residence. » (htiws~riiéie “© % E 4 € - . = - . * a fa ; ib - AL ; ¢ cy ck amude: saa a Ke 4 Place of Burial. /4¢A 44-4, EN ce ~ Gtr Cemetery (7 4éecg Adee~ © SE — ¢ OO. ce, oe Funeral Service at * Lot No. | Put in the Diagram one mark like this f ( ih ‘or 6 » Grave 7 . Vine of Sesion 4Ce lee hl oo aie fF Crea Ma. i i for every Grave in it. And mark thi F 4 ) Burial with double dagger thus: t ate eon a Gantt | Date of Interment ——— es ee Designate site of monument thus: C) a pee ’ _* . SU Casket or Coffin No. ik Lec fe AOC Candles i | | é | Size Made by | Gloves i Lining and Pillow Set No... Bearers or Porters i | } Handles | Hearse to Plate = 2 / f : i Removal } ; f > Ht i| Outside Box y * ‘ age? UA cry \| Coaches l tals vhs Js. | L100 | Burial Suit Ce kf AA re | Slippers Newspaper Notices i : . ; | i Embalming oc i Washing and Dressing i tl i | : I | Shaving | } : i| j | Re isla i| | | ervices || | Use of Chairs ransportation Charges HI Church Charges i | Officiating Clergyman i] | j {| | a 4 ey Cemetery Charges i] | | Amount of Bill 2 |OoCo f | } | Ja Oo a Music | } Goods Ordered by OA LAK aes 4 il | F - “ i Flowers | Bill Charged to } DR. L CR. / a . v oT, es . ff oe - CCheg Yt XO Ce £- (22242 C | oo ee. 5 cht UL ; 10S ilies sie ccna ebsites ka | i 18OVUED BY OORNTEE CASKET CO BOSTON MASS. 1016 enn RECORD AND BILL OF ITEMS Nn (LLAFE eG Je. Lke' cee Mee tech ‘ Poche, YO CQResia Siaug Hf 2 to C sy a € — or Widow of U ie Residence Place of Death s Date of Birth pf € ) g BIG f /.....Years Sex onth (Day) (Year Date of Death Qeog if Gig. 3 inl 4 Months 4 Single Yes Me 4. (Day) (Year Maiden Name y, L / V Days | Married Birth-place Na uly Name of Father Lk LL ll de ine Maiden Name ff Mother ee TM Leathe» We LEGNZ Certifying Physician b Go ok. e.. Place of Burial “hah aa [ J pf. Funeral Service at 3 PV : Ai, ry - Time of Service (ti20 ¢ 16 Date of Interment / ( Jecupation His Birth-place Na was @ AG Leathe) — te, Birth-place Preheee @ A@ Na fihic a Sh Moa y cbt. PeeCE Cause of De ath Primay Secondary __. Residence AC 3 Cemetery Lot No. Grave No | for every Grave Section ff : 4 a. COO 0) Candies Gloves | Casket or Coffin tak) RHE A a Size Made by Lining and Pillow Set No | Bearers or Portgrs ; Handles i eiin py aaa ~ Lec Ar Plate Removal Jeecce. “al glow eo Re - Outside Box or Vault Coaches Burial Suit Slr ehtrcy 7 Slippers Newspaper Notices Embalming W ashing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charge Officiating Clergyman n4. Yearly No. df FOR THE FUNERAL OF Tota/ to date Color y Race Put in the Diagram one mark like th in it. And mark th Burial with double dagger thus : + Designate site of monument thus: { i aa, Cemetery Charges | Amount of Bill O / ‘? ad C , Seen Music : Goods Ordered by he. Ll pbMlariza. Flowers Bill Charged to DR. CR (Deag M/1q|_ So gure Of Face | 1/4 oOo TO eee | reap. 1) Ly iV 4 1/9 PZ i| _ cecal i _ = 'S8URO BY CORNTER CASKET CO. BORTON, MASS. tete —|- | { we Yearly No. Residence Place of Deat!: 23 . RECORD AND BILL OF ITEMS > FOR THE ae OF Total to date In & ™ [bautg ( Jta) RU Cae A © Ll Ly hh C4 Almet go Wife or Widow of ©. Date of Birth me 7 19 f VT Years Se Color or Race Date of Death “ 2 kG” fF se 19/9, ed Months 4 Single Maiden Name hae ke Ke A = le L Days | Married . Birth-place “Ya MA Cer xe _ Occupation s Name of Father Ke aude t Pa. His Birth-place Oa lt Geus &% Zz e Maiden Name of Mother Faller et OW A Le ler Birth-place or : Cr Cause of Death—-Primary_ 4 f bv arte Ch. i Secondary Cece tecca a : Certifying Physician AY v L G C0 x <————_ Residence <<“ htow cle, CE2 ’ Place of Burial! c LYK Ca4 rs ZC e Cemetery Funeral Service at / fed Lot No. Put in the Diagram one mark like this a ee cay. See a oe inetd sth date ger aetg Date of Interment c -- Section 1 Siaataeeitiabivel adenine rr ~ Casket or Coffin No. Ye L4v€ Def he. Lae Candles | Size Made by Ney ¥TCOO || coves | Lining and Pillow Set No... Bearers or Porters I Handles Hearse to Plate Removal Outside Box or Vault 40 ae Coaches | Burial Suit Ks kee Ivo Slippers re Newspaper Notices VV Ic? || I Embalming Washing and Dressing Shaving Services Use of Chairs fransportation Charges Church Charges | | Officiating Clergyman —— Cemetery Charges | Amount of Bill J . v-@o ee Music... } | Goods Ordered by 4 ta, & ST “a Bo he Jaere RO, Flowers Bill Charged to i = _ DR CR. Coeg {T//e U0 Gene (Lece | e CPO AMG NY vii &, “heck a IEolco || | = | | | | ase =| | 4 i} | | j_ - 7 | | | | ; | | | } | \ am | SREP 5 ee = a pre licenenseiiliiemen eminem 1SOUEO BY COMNTEE CASKET CO... BOSTON, MASS., 18016 sacar it ; RECORD AND BILL OF ITEMS Yearly No. / 1 : ; FOR THE FUNERAL OF ~/ 4 : ‘Ate Cpna tL CRE ALLE Nath UckLke, evo “Kk Cc K fe > (ht ttn ch Le ie Total to date Residence Place of Death Wife or Widow of / . 7 (/ ¢ 4 7" “ ’ Date of Birth be TF iL . 19d \ is Years Sex ‘ pa or Race onth i (Day) (Year / i f 4. J Date of Death Ck AAA Lf. 19/9 Age “Ly Months Single ki Le AB¢ I FCELL v Month (Day) (Year) ; on Maiden Name / A ss i Days Married A Ys f es ¢ LA ‘ Birth-place e : Occupation : (Cas (t/ @£ 2 — ( - ¢ & A ? Name of Father oe si —— His Birth-place i{ / £<- tx 2? é h | sahrzti (L4 - Maiden Name of Mother? A«-# OL Li p EMA AE A Her Birth-pla¢e ee e arf f | Of al Ra ; Cause of Death Primary ~ KM thee fe hi c > As Secon ary / : wet: Lé Sat eobeeeenl J ~ / / Lia a Ake i¢g ty 7 A & lg Hii £2 4 l r / ‘ =— ¢ are —€b ge er thametery = Certifying Physician Residence 7 hey, Place of Burial : td ¢ 4 “ ' Funeral Service at f Lot No. Put in the Diagram one mark like | Tins of Service Coase No I for every Grave in it. And mark ¢/ “yA cee - j ; Burial with double dagger thus : j Date of Interment nf l 5 Section Designate site of monument thus: [ ] a ‘ (ceo Soo Sct Bie ae = gee ee SSS So = oe : i Casket or Coflin No L{kL Adee pe he wn Candles | Pd “4 I Size Made by “A Agee [7 eX Gloves } | | Lining and Pillow Set No Bearers or Porters. | “y | i J ( £ A_ On & & | Handles Hearse to : Ld | j oe Plate Removal ek AY Bo: A | Outside Box or Vault Coaches Cy K/L, 4 be Burial Suit Slippers : | Newspaper Notices f y f | | mbalming . ic | W ashing and Dres siny i Shaving | Services . 1 : we ? . Use of Chairs Transportation ( harges Church Chargs Officiating Clergyman Cemetery Charges Amount of Bill ; fcc — 7 ( Lt QD & MELL— Music Goods Ordered by ¢ 1 ee - | f A 4 f rd | Flowers Bill Charged to 2k RA (IAA i - DR oe CR ( / , Vs ie ct | { { ; | t| ~ ie A_2_f | ie c oc oma ihe - | J <4, fs ag L~ i 120 mec / } - | bn | i i} i | 1} | | i | i | . | oe “ | _ | | | ‘ | | ssn || . | | | | i iI s | } | | — - | | I- i— ae | we m= | 4 'S6UEO BY DORNTEE CasKeT CO, BOSTON, Masse. i818 Yearly No. / Vv ' x “f CLA Ct Residence Place of Deat!: J ‘ (Hla Md vi lhe Héectl CSe"g Df" (Month (Day) Maiden Name 4 , ~ a Lf aa , ae @ Date of Birth Date of Death Birth-place Name of Father Maiden Name of Mother a + Cause of Death— Primary Certifying Physician f Place of Burial Funeral Service at Time of Service Date of Interment vr ’ Casket or Coffin No.. (c* Af re, Te Ae - RECORD AND BILL OF ITEMS sf C4. @26 LG f fitig cy FOR THE FUNERAL OF Tota/ to date Cur eee (4a) Ci f WQACL TL A¢ sit yy . Lo =. ” Wife or Widow of 19 | & § Years Sex Age Color or Race (Year 1 ¥ Year AE Months 4 Single Days Married Occupation Su, cc1er > His Birth-place Her Birth-place Secondary Cemetery Sh / i Residence WF LLA t @ A a“ x “ Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: Cl) Grave No. Section f Size Made by Gloves | Lining and Villow Set No... | Bearers or Porters i] | | Handles Hearse to Plate Removal i} j Outside Box or Vault ‘ Coaches | c Burial Suit | c |@ | | } Slippers Newspaper Notices : I } Embalming a or : : Y (@twug y wis II9O oO Washing and Dressing Z =f / | Shaving bein. eetcon CCS sb j | Services | | Use of Chairs | J ransportation Charges Church Charges Officiating Clergyman niniiiiianaiiapeigi es ’ | | Cemetery Charges Amount of Bill iti? = } | | Music oe | Goods Ordered by Mha-spia Gereffi | — | Flowers | Bill Charged to.” » 0 PKotlauey DR. CR. , Sen a ene megan , iti / : f) a Leen mt 14 Jo Risrf— ieee Sooo, Ay HI | a 1 usd i | _ i | i} and | | _| I | - : ne —_— - i 18OUEO BY COUNTER CASKET CO. BOSTON, MAGS. 1010 ail = ee ee nes ) FOR THE FUNERAL OF Yearly No. Residen e dd Place of Death i i Pere gam Wife or Widow of Date of Birth . Years Sex Date of Death : Age Months 4 Single Maiden Name pe Days Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death Primary Secondary Certifying Physician Residence / F > Place of Burial ug Cemetery Funeral Service at Y Lot No. P Time of Service Grave No. Date of Interment 4 Section eemaaee Casket or Coffin No Hear Candles i Pale be Lining and Pillow Set No. ¢ al Qeehly vs O\0e Bearers or Porters Handles Hearse to Plate Removal A Gusts ms Nee/de 2 O loo Washing and Dressing a ; Shaving nuek ba elt, LQIOc Service: —t f 6.021432 /0 | se Transportation Charges a Officiating Clergyman Outside Box or Vault Coaches / Vioe Lv Burial Suit Slippers Newspaper Notices Embalming Use of Chair Church Charges Amount of Bill Cemetery Charges Flower 8 Music Goods Ordered ee 7 | Bill Charged a tpi two) / RECORD AND BILL OF ITEMS Total to date Color or Race Put in the Diagram one mark like t! | for every Grave in it. And mark th: Burial with double dagger thus : 7 Designate site of monument thus: C] meme So sacar SRS RR OES Eee mee DR. tea HF 19 Jo Qrrset- of ! A Ak. 2 o/s is oO { te | } SE oad et | Roe lO] (dh, @ 1S8UEO BY DORNTEE CASKET CO. BOSTON, masse ere RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF Leh 4h AZ x A , Mle a ~~ t, f-- : Residence Jers ie fas cal Ag / +3 (ie rin F — SMM se ch Ra “A e Place of Deat': Wife or Widow of Ao Date of Birth o ~~ S99 ¥ Years Sex Color or Race Date of Death <g ft 147 1977 Age fc Months ¢ Single OKI. Maiden Name ., \ — ce = ne ) Days Married Birth-place bi a ead =e Occupation POY 1 £ - ay ae 7h SA * YS tL c. His Birth-place Name of Father Maiden Name of Mother (Leeegure;/ a SFC +. Her Birth-place ~~ / J fl Ce ee Me ee ha 4 Oe wee Se. Tota/ to date S Xe A € So. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: f Designate site of monument thus: Cc] Cause of Death Primary (2 pfs { ¢ a £ ax fc 4 : Secondary Certifying Physician * By E Residence ‘ . > Place of Burial 14 : €4 Cemetery Funeral Service at Lot No. Time of Service =H" E Grave No Date of Interment Section 7 cee oi meeaipsei Casket or Coffin No. ss ; a he Candles Size Made by | Gloves Lining and Pillow Set No... | Bearers or Porters Handles Hearse to Plate Removal Outside Box or Vault | Coaches Burial Suit ; Slippers Newspaper Notices Embalming Washing and Dressing : Shaving | Services } Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Chargés Amount of Bill Music... | Goods Ordered by Flowers Bill Charged to DR. CR. fel | Jo aeuk leer A OLN, Se 7 ae - | - | | | a — | | } — | | | | | 1] | “| : ee | rs | | I | _| - | I - . ‘ oe | | } | | | id 1SSUEO BY OCORNTEE CASKET CO. BOSTON, MASS, 1018 } RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF Tota/ to date x =o f “Ww Residence (BAL vik & K & : Place of Death u' .! Wife gr Widow of } Date of Birth K - Ga | (r2 a) 19 . : J ~/ . Years Sex LEAKE Colgr or Race Date of Death a ; : e 19 : Age 4 Months 4 Single oe "3 ' Maiden Name 2 Days Married Birth-place / _ . Occupation “2 as Name of Father BLE | eo His Birth-place ALLEL Ce A. gail ' 1 Maiden Name of Mother Ath i a4 f nA Her Birth-place C . e Cause of Death— Primary ie Secondary Certifying Physician NAL KA, = Residence Place of Burial € 7 oy & C's Cag ( Cemetery j Funeral Service at — ot Me a Lot No. Put in the Diagram one mark like this : Time of Service Grave No. roy Gorin Anda Date of Interment xs + Set Section Sitiien lek al ainiiiesda Bins - 4 { py of ee bia sp | ' ; Casket or Coffin No. AB ea cet Candles | Size Made by Gloves } ! Lining and Pillow Set No Bearers or Porters | | 4 : ‘ ¢ i eo | Handles Hearse to comes ee i ' Plate Removal | Outside Box or Vault a Coaches } Burial Suit °. O92 | Slippers Newspaper Notices | Embalming | | Washing and Dre ing | Shaving Services j Use of Chair Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill gcse easels ooo! Music Goods Ordered pyheck [heen Y Aut KL facie we 5 Flowers Bill Charged to fe “ ll on | <oseseeneensenneeneeemennsanaatan cissitdeiaiaclicea iiptihines | DR. CR. | Hf] (4 Jt Orrick hide, 35\c oO vik# F paw ke ee Z0\0% | aa. al cocesnetell #5 | Lap ae Z Ay J . | - ANT / Se 7: By [us tang bn, + OO | | | | ae mt. ‘dhe j 7 — i} | | | i | | | y | } ; | _| | i ; | | | ein | | : | | | | 1S8UEO BY DORNTER CASKET CO. BOSTON. mass tote RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Yearly No. f. as. Apt tf. fv A_2£ fA a Ahaiesi f QLL, Residence ee eee Vi, eri. Oe Date of Birth Date of Death Je Pr 7 Day Maiden Name sa — Day Cat htgece Co “KH Birth-place x If ; x 4 i A c Name of Father SZ (Year i9/ € S / Year Years Sex Color or Race Age Months § Single } L Days | Married L Occupation His Birth-place € ath tuec Tota/ to date Wife or Widow of 2G Loa ; : : PD @a . aie a2 DP « 7 . Maiden Name of Mother ./ n 2 le ta -- te ef Her Birth-place @k HAteecn, YH F.C = @: ss ‘ ‘ 5 » j Cause of Death—Primary. “AC tiv <tg GHLH ‘eee o Secondary £Cecehe hedefatia _ Ct o> 3 ; at og CC —/ “Se of a Certifying Physician \ = “4 CEL Residence At+MKk hey ck Le WK Place of Burial Miirsr.ste Taek, sX¢ Cemetery { . al Service ] | Funeral Service at Lot No. | Put in the Diagram one mark like this Pins of Saesion ete hes : | for every Grave in it. And mark this fy P 4 Burial with double dagger thus : ¢ Date of Interment kik f* 7 Section Hee ‘a Designate site of monument thus: Cc) 4 i ie eee, . aE aa . ; <p» Kt j . Casket or Coffin No. Wa &f UBM Ke te} te Ge Cant. | | : | | i Size Made by Gloves " | | i Lining and Pillow Set No... | Bearers or Porters i | a : 7 i : Handles Hearse to “eorsets, (RES le a ! | } j { Plate Removal | Outside Box or Vault Coaches be | Burial Suit 7}0 | | | } Slippers Newspaper Notices | 6 Embalming ra ° c | | Washing and Dressing | ocr Shaving | | | | Services | Use of Chairs | ‘Transportation ( harges | | Church Charges Officiating Clergyman Soa i re Cemetery Charges | Amount of Bill ; Z¥YJO°o f pee | Music Goods Ordered by /C4¢24¢la =O" A 24 k, Bot St L fy op 4 f aad | Flowers Bill Charged to ve hase A. Pe | DR. CR. dé “« EENSTEAS: = So EN 3 aaa ee aR _ j === = —- Eee ars 1 Pa 7 crn MOMs VO Geek Aces L\0¢ tA, Ces ox, IGOC iat eee - , } a it | - / % + - ; at | A ‘yr 1G is 4 f 0 0 | i | | ; | 1} | d | i H i} | } | —|- 1} || wl _ I i i | | | “| l ! — i] — j 1 | = | ae = | | . | | | \ | 1SSUEO BY DORNTER CASKET CO. BOSTON, MASS... ns Sa gs Ne re 30 RECORD Lee WD Residence j Cf fe k & Place of Death Yearly No. »/ AB AND BILL OF ITEMS FOR THE FUNERAL OF on ( 47 Wife or Widow of Tota/ to date / ( Ps Date of Birth //L6 of . 9 / ¥ Years Sex Color or Race j bad (Dey (Year ff a 4 Date of Death f fe # is 19/7 Age o Months § Single “s, C7 LE TH C£K 4 Month Day (Yéer) o f } Maiden Name 2 | } Days Married C 4 k ( "e ° Birth-place j i se \f € ce€ Occupation , / (le " . y F 4 - a a t. Name of Father OAM —/ | CUE fof His Birth-place _ rUKLlkk Coe Ae Maiden Name of Mother CLK Uy AALLL l Her Birth- -place [* aw Sa ewrha, C% oD a Cause of Death. Primary Secondary hie ss L Certifying Physician Bee nt toee be He Residence A] Lig Lhe -# - Place of Burial ale 1 hl t Th AB ag C& ten, Cc tA_eer C Ly I N f Funeral Service at At No. Put in the Diagram one mark like this . ‘ iy Gs LER pa | for every Grave in it. And mark this Time of Service } { f Te, / s Grave No. 4 Burial with double dagger thus: ¢ Date of Interment a / oo Section b : Designate site of monument thus: 4 | ‘ ees Etc a = _ —e = ae Neer ee il t q Casket or Coffin No Candles i | * Size Made by } Gloves {| Jd Kk 1 Lining and Pillow Set No {Vv de Bearers or Porters | “ } i} Handles L p ’ | Hearse to i| pt’ : | } Plate a f ‘ | Removal i ey, 7 0 I Outside Box or Vault ; . (i & , a n/ ¢ Coaches || ) { k op “4 i] Burial Suit l t { \y Hi . C6 \ i| Slippers | 2d Newspaper Notices | } { | Embalming A . f | Washing and Dressing I Shaving ! | Services 7 Use of Chairs Transportation Charges | Church Charges Officiating Clergyman | ey Saree Amount of Bill J te J OLO Musi Goods Ordered by ol f_o- + A ‘|4 Cratf | t sig KK Maus/tn. Flowers Bill Charged to a | DR. CR. ee ? ~taaae - cia a = : Udtrect (Lect JIoloc eet Fi /F4 Ly Sei ole | A emNNA — " i . | } | | | Poa | ‘| | i} \| | ) i i| i ; | ¢ | | I i i i i _ l] | Bisa | | | | | | | | etn woul te ints " . | | | is | | = | | : I a tt IS8UEO BY CORNTER CASKET Co. BOSTON, MASS. 1018 RECORD AND BILL OF ITEMS / FOR Kg FUNERAL OF Yearly No. Tota/ to date A ._f f Cier Ceyet 4 y woth wh, COL. MD lts ackle Residence Place of Deat!: Wife or Widow of. / Date of Birth ct / Te é f Years Sex ttcea (Month bey) as ear Date of Death << AF 4 19/9. Ages Months 4 Single Month) Day (Year Maiden Name L Days Married x 0? ¢€ ae Birth-place FR KL LS . “€ Occupation s Name of Father "EAL (t-¢eLee@ is. His Birth-place eh exe Av Ge ae Se €2 — : Le ro te hohe Her Birth-piace eA LEK C hide C Maiden Name of Mother Cause of Death—-Primary.__ ; Secondary Certifying Physician ri J. Ma lke ha 7 Residence Cemetery Lot No. | Place of Burial Funeral Service at Time of Service Grave No Section Date of Interment Color er Race (Ce C Put in the Diagram one mark like this {| for every Grave in it. 4 Burial with double dagger thus : ¢ Designate site of monument thus CI) And mark this Casket or Coffin No. ee Po i / O10 21! Candi | eee | Size Made by FO } | i Lining and Pillow Set No.. Bearers or Portgrs : | { o {2 a : i gl Handles Hearse to CAL AF 8A | 1 ¢ Plate Removal Outside Box or Vault | | Coaches i Burial Suit | . ‘ i Slippers vewspaper Notices | | Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman a Cemetery Charges | \mount of Bill | /4| Oe 1| | Y ea Music i| Goods Ordered by Mee. Covcka a. | Flowers Bill Charged to DR. CR. + _— ‘ sionmpeennsnnencenenesenei a oe a Tee t . . zt J UC/ f (9 Ya Cmeeek (Le CL [I ¢ COAL /7 awe & GeO . ' Pp) we ‘ ae | 2 fogabs P ano | i| Fa ‘ | | Off rf As Ft. & | | rm ; } | fi Vy *t /\e | -| | : = | i} f im } a } | >, 1 IC | 1] a u uv | | / “er _ | rm | - ; ; i} a > H 6 _ i] 7 } - ~ { —| he 1,.C° 02 7H) i | H 1 _ | | \| | | 4 | al i i | | | aa es l - i i ISSUED BY DORANTEE CASKET CO BOSTON. MASS... 1816 " RECORD AND BILL OF ITEMS Yearly No. Iv FOR THE FUNERAL OF Tota/ to date | * = Residence halk BK C Place of Death oer A oC Wife . ae of ee Date of Birth Gg 6 | Years Sex } ; —_ pr _ o Day) (Year) / ” Date of Death ‘ 9 19 F Age ; Months 4 Single Ye 1 Day) (Year) \ Maiden Name | /.. * Days Married ( — Z Birth-place Vib RL oO $y Occupation to , - Name of Father / . # KK af His Birth-place Kt244 OBC os Ug or aod } Maiden Name of Mother chy «Lg MRLG He *r Birth-place . af | Cause of Death Primary® eliotn Secondary Certifying Physician Sd phe ss th - Residence ys Place of Burial 2 * UtlheceS A od Cemetery Funeral Service at Lot No. | Put in the Diagram one mark like this nm os : ' for every Grave in it. And mark this ; Time of Service A v Grave No. ! : , 4 i , 4 Burial with double dagger thus : t Date of Interment \ L 4 Kies Section ; i | Designate site of monument thus: CJ =f i | ope ~ a Soo Se es ossEese — = 3 | z Casket or Coffin No 2 ov ih et Candles i | Size Made bel, 2 2, ue Gloves . { Lining and Pillow Set No er. ral Bearers or Porters 4 Hand} ko C it \O Q Hearse to | 1 andies "™. : sarse i} | ‘ ial | Plate Removal i Outside Box or Vault Coaches } Burial Suit i Slippers Newspaper Notices | Embalming i! ' Washing and Dressing Shaving i services “3 | ‘ Use of Chai: Transportation Charges { Church Charge Officiating Clergyman ‘ i OGH | Cemetery Cha Amount of Bill ; 7 mu wo Music Goods Orde re od an i # fe m4 ry ; i £ Flowers Bill ¢ vharge od Q, bY pees eb Lary & Nich, pfoalel aa. a rial stea cee “e i DR. i / CR. i pi Lory. b Ye fr a. 5] ma f | ,. : KeFA Yi Yo 4 + PELQ, IO! eet of q I, Cheek —"_ || @3loo | H - + | i | By " iF } | : - —| | ; | : | / | | ' on “|| : i i | | 7 '88UEO BY DORANTER CasKer CO ,. BOSTON, Mage. tote 44 Yearly No. ' / Thy VV. InG Ov « ft / cS HLL) “MWY We okee Residence Place of Deat! Date of Birth 1y (Moath Day) (Year Date of Death 19 (Month) Day Year Maiden Name Birth-place / Name of Father Maiden Name of Mother i Lb 7 A hf hu Cause of Death dL, L¢ fo abek : A £. Py - fa. Primary Certifying Physician Place of Burial trp (101d peer Wife or Widow of , e f Years f Sex Months § Single Days | Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Thee ts Sas Funeral Service at Lot No. Time of Service Grave No. J Date of Interment Section 7 Casket or Coffin No. Candles Size Made by Gloves Lining and Pillow Set No. Bearers or Porters Handles Hearse to hax gre fv&Coe hic Plate Removal ¥ hf Cc14s.ee bE Ban Outside Box or Vault \| Surial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers eae SE DR. (Lete & bY le hs Ye — | {| i | i “| | | 1 “| | | | Coaches 4 ach lacech 7 A/f on | for every Grave Burial with double dagger thus: { Designate site of monument thus CI) 33 Tota/ to date Color or Race Put in the Diagram one mark like this in it. And mark this @ © <« f F& as | J@\0 4 | AHeo Wayage Lag sé t | | | | | t é ' | } Newspaper Notiges } J Jo ° ; og 3 “f y > ? - VF f Lt ee =, NK if 9 i’ ¥ ~ . 4 (t -. 9 | Lv ¥ y a | ransportation ( barges Mine ny lergymi Officiating Clergymaga sniciaiigillcincan Amount of Bi : , eo] > (Goods Ordered b ~ | Se ) 62x LA fray HY ied ase, ne. 1 serceggggnsninensienmensennimenmnenansenenenses neti afe 2s 6 CR. = 7 FR ( ; Ne lle (C4, C4 Urine / il I 188UEO BY DORNTEE CASKET CO. BOSTON, MASS... ceeretinhaaietmtinti isin Le ee ee RRECORD AND BILL OF ITEMS Yearly No. — ~ FOR THE FUNERAL OF 4 ¥. Wi ets ik TT u The Yy 1.4 Qe, AE dence } na . Resi ri - a J MO Civ hee Total to date Place of Death : WwW ife oy idow of he }¢ r Date of Birth “ : {' y i$ 4 ] f ’\ Years Sex A. mL Color or Race Jefe > aw 7 | oer ; Date of Death } 19] 1 Age Months Single 4 Cys Lh : Mvath Dey (Year | / / PRIN Maiden Name —- F Days Married ‘ f § ti“ha 0 FT ud Occupation é THE. AS. Toul Ul, Hl (C 7 Li Navteta Birth-place 7 / - (Cc Name of Father /: I = UL £ His Birth-place Ls Lir Axe Bes © a fe } J ! (¢ f iC a hd ABA ( “WK gen er Bi h-place a fecha ‘o AL ker? aT KZ yah PsainS an tt. “Residence \ TOL e yet by KA 4 Maiden Name of Mother Cause of Death ets Certifying Physician ; fc { 4 o . Place of Burial /} 4 a 5 eyo a czar Ch Cemetery | f f | Funeral Service at A Acute . Lot No. Put in the Diagram one mark like this i 5 : peo ae | for every Grave in it. And mark this Time of Service : f ¥ / | oe Grave No. 4 Burial with double dagger thus : t Date of Interment L—" ; Rhee Section | s , yi : . om ‘2 Designate site of monument thus: _ alia iil aaa lesa Casket or Coffin No. fia. Kors how Ya [vac Cc Candles ia ea ; Size Made by Gloves Lining and Pillow Set No Bearers or Porters Handles | Hearse to Plate i rox 1 Removal 1} . Vanttcce 87) hey. eee I ' / j j Outside Box or Vault Coaches J c Burial Suit } JC i] ‘ i eo Soot Slippe rs Le fra AER 7 Newspaper Notices i} -) /| ¢ Cc | Embalming |] Washing and Dr ng | Shaving Services Use of Chairs Transportation Charges | Church Charges Officiating Clergyman Cemetery Charges Amount of Bill / J f 4 “y Ah: Ofte Music Goods Ordered by Flowers Bill Charged to f te DR CR. ee EAE LU f f- 2) KY C Q cary ft can. v0 A ) f |-L2q_ Ch 1 Ok ia | i| | | -|| | iH] i| | | sialic | , = 1S8UEO BY DORNTEER CASKET CO. BOSTON. MASS. 1810 Sg A ges EE: v RECORD AND BILL OF ITEMS Yearly No. BS FOR THE FUNERAL OF Total to date ny zy Ch Lk Le i hevee e OT, I~? ee A Residence L Ld vO Le “ ‘ Place of Deat!; oon hy Wife « r Widow of roi a / a iv/ Y f © Years oe . & aan BL 2 : avy or Race Pee . LM hes 7 (Day) 1979 Ne y Months mena fo. = A (Month) (Day) (Year ‘ 4? Days + Pde. Qe ne. Occupation = Leh aneak Gin -pace Ate th lew h _— BG AL. Date of Birth —~ Date of Death Maiden Name Birth-place Name of Father f' bh C / i r Maiden Name of Mother. <<< £4 AO - . Her Birth-place ee 4 4 Cause of Death— Primary Secondary re ‘ = e a _ -_ : rs a -_ Cortifyinig Ph: sician OAL £2 LZ SyResidence £& eq OCipard Cemetery 4 fee. ae C22 © o = Lot No. ie | Time of Service - % Lm, Grave No. d oet S/F ae Section | Designate site of monument thus: | ze — = “) P eee cereal ee an seer RIE ; Casket py No. Bo od Loc as Candles | | Oost | /%F90 Cloves | Place of Burial Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Funeral Service at Date of Interment Size Made by Lining nd Pillow Set No.. | Bearers or Portes Handles Hearse to e ia Oy LE | Bs : % : Plate Removal V 3 B A Outside Box or Vault oc fae 5 See Coaches Burial Suit Va. —r r Slippers v | Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges | Vv Officiating Clergyman Cemetery Charges ZR + Amount of Bil M sic Goods Ordered by Flowers ol ISSUED #Y OCORKTER CASKET CO, BOSTON, MASS, 1090 REET Fa Se Siireeeieen Gi ecee ee Yearly No. Z 6 st Residence Place of Death tr ‘Lal Le. Truc, | a 4 vu Faas QO-+D fe GSS ee RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date (L.¢) AL Date of Birth sas = 19 . Gare Sex f Color or Race De opth ay) (Year Date of Death Cet / <2 gpie. 19/7. Age ‘Months Single engl ae . h Month 4: ey (Year J OL Maiden Name Of ; ; a) ie {ADays Py op - o t 2 a : Birth-place tL b Occupation u LOL Cfo Name of Father Maiden Name of Mc Cause of Death Primary Certifying Physiciar Tseehh. 1 Pryce eee Q de ha bots, 2 VR, .. Her Birth-place OT TOLW 21 4 ae y= : ecu, hy <a Secondary b~ &/ > *Kesidence KA AOL, cLe. WO His Birth-place Place of Burial Q . Py } /] Kk Ch a Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this en al Camvinn : Crive No. 1 for every Grave in it. And mark this s Burial with double dagger thus : t Date of Interment Section Designate site of monument thus: es 7% en —— eeenenannn Casket or Coffin No ‘j[@ ty kyo VIG Candles | Size Made by Gloves | Lining and Pillow Set No Bearers or Porters | Handles Hearse to | Plate | Removal | Outside Box or Vault A Coaches | Burial Suit : aN P Slippers Newspaper Notices Embalming | Washing and Dressing > Shaving ha Cha iis Cy Ro Ase io. Use of Chairs 6 SON bs if Rn q P rs Transportation Charges Church Charges > . (\ Rinse. Om a Officiating Clergyman | Bic Cemetery Charges : Amount of Bill | OL Music Goods Ordered by (3 fa. Pesan Flowers Bill Charged to ress rohan C | | iii sili | DR. CR. a 4 ; o8TW | Jo Rae |_lyseo] eet Wf] My Chek | 77 ape aed — iin | | | | iaaaiialnrcnneil i 1S8UEO BY DORNTER CASKET CO. BOSTON, wASS. 18018 ms RECORD AND BILL OF ITEMS r Yearly No. “ Total to date FOR THE FUNERAL OF LA» VK 2 poe Fyeceunle Le, Fe Ci Oliyy Lee — A Wife or Widow of (O $63 ¢ FOvearn (50 OSE memnf IE hed Feats | Staats | engl | loth Occupation site sai For. 7 [ 7 Days | Married Yod os, > Name of Father RAs wre 2e — His sirth-place © “a2 2 RQ ARQ 2 Q G > . 2 AQ, Maiden Name of Mother Mya elle eape, Her Birth-place 7; Co ae o haddr. é : Me gest (AM Let tip 41. a_ _—tesidence. V1 RA voha UD haek Nauta, Cb rroodtebes p20 Leswee B- rr ay Lot No. | % (Om Grave No. oeR sv 1G Residence Place of Deat!: vahs Date of Birth Color or Race Date of Death Maiden Name . “7” Birth-place Cause of Death-—Primary Certifying Physician Place of Burial Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: ¢ Funeral Service at Time of Service Section Date of Interment s neta Designate site of monument thus: C) LQ ae Sees LEA Riek hu vs oo Candles Size Made by | Gloves | a Cha | KI\00 Casket or Coffin No. Lining and Pillow Set No... Bearers or Port Hearse to Handles Plate Removal Outside Box or Vault fp Coaches | Burial Suit 0 |O0 ~~ LS ) os Slippers Newspaper Notices Embalming A | i : rh) “| Se oO! Washing and Dressing Shaving Services Use of Chairs Transportation Charges | Officiating Clergyman Amount of Bill “ J ld | Jitsy Geo QL Church Charges Cemetery Charges Music. Goods Ordered b 7a Bill Charged to rat & oe re j Sona Flowers DR. em CR. i ao eon me . haut . CRY lig Jo bere iy LILO OeAb/F| Vey eA | (wo if } ! i y | — | | | ; S = LG ST | | | | | | | = ao . seas pian i eat | ee ci / ; cal Me Becton | | a. a. cee hee . anne _ —{ ——__—— = oe — | . ane sctereninninaincimnesncinenhisieilia sesisiiiaiaiiiiladi | s | | i ISSUED BY CORNTEE CASKET CO... BOSTON, mi | H | 4 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF ALO a) Place of Death Votar, sgt “s Wife or Widow of Date of Birth 5 a" UY Years Sex Male (Day) (Year a . Date of Death a J ee Age O Months ¢ Single z ee omth (Day) ¢ (Yeqr) — den N oo Retr Maiden Nz Days Marrie ev 4 Occupation hale Lee ___——— Maiden Name Birth-place Mnpas” : Na ue of Fathe a ‘ His Birth- -place agtae! © a he WO eee, Her Birth-place FH, & Tota/ to date Yearly No. J ¥ Residence Color or Race Maiden Name of Mother Cause of Death Primary 7 Bagocsn at (h 2° a PON: tay kf lb CudeBeitals Certifying Physician c TA M422 Lesidence i, ucQea *O Place of Burial i Cemetery fVarcee — se Grave | Yo. OefL / Bf 76 Section Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t I uneral Service at Time of Service Date of Interment ee . Designate site of monument thus: CJ niieve 7 piapiieiiieaiiiaiaieaasiiiineniaiiias ; Afi Cie“ Tooee) cnim Casket or Coffin No | Size Made by Gloves | | Lining and Pillow Set No | | Bearers or Porters | | «Lolo Handles | Hearse td UD Ge = Par Plate Removal Outside Box or Vault Coaches G, fo Debomarhe/ | IS bo \ a Reed Lo 2 Ceerke erreps ry | Nespas Maite | Wo O | Burial Suit Slippers Embalming W ashing and Dressing Shaving Service Transportation Charges i Use of Chai: Officiating Clergyman Church Charges Cemetery Charges Amount of Bill Music Goods Ordered by Pr &. Flowers Bill Charged to { SR Soenae f hy (9 o | | | | | | i} | | — 1S8UEO BY CORNTER CASKET CO. BOSTON, mass. tow . RECORD AND BILL OF ITEMS IG FOR THE FUNERAL OF Tota/ to date Pritee Td lock Ken. Co. LL 6 * oa ja —— Yearly No. Residence Place of Deat!., , VOC r« Wife_or Widow of Lh 4 ) Date of Birth ef % (Os } [ Years { Sex Color or Race _ (Month) - ¥ Mong Ps var) g aH Date of Death —— hes Months Single < SEAL ‘ieaky nei (Dey) (Year) Maiden Name i Days | Married Occupation Birth-place : oS fan, His Birth-place . p~~ } Name of Father + o Ay ~ Maiden Name of Mother eee Her Birth-place Cause of Death—-Primary Secondary a ea Certifying Physician ce Residence en, >) Place of Burial a - Cemetery Ao A ~ LR Oo~ Put in the Diagram one mark like this J} A. "3 4 ( Dy Piven Me: { for every Grave in it. And mark this 4 Burial with double dagger thus: ¢ 4 a A A | 7 Section ' | Designate site of monument thus: | Funeral Service at Time of Service Date of Interment leo oo Candles ee Casket or Coffin No. Size Made by | Gloves J Lining and Pillow Set No... Bearers or Porters rs See hen — j Handles Hearse to | Plate Removal l : 4 Cove @ »,°°- 2.0\00 Outside Box or Vault 1 pil Coaches 2 ) A-C surial Suit o N | Slippers | us Newspaper Notices Embalming Y 0 O || | | Washing and Dressing Shaving | Services ! | Use of Chairs Transportation Charges Officiating Clergyman 1s 3|50 | j | | | | Amount of Bill se bie Bo ~~. | a »y rg-tece eel. | | } ; | Church Charges Cemetery Charges Music Goods Ordered by Bill Charged to Flowers DR. CR. 7 7 2 ee EY a a oon wiiniaes ss Yor, Wy 1G. iP @Prreh he K@_ 7 eF i? Ds 4X = /, ¢ J sa Kez, a A. 4@©o CO ~~. ++ ia a J | ead 4 a | ; | ; : | oe 7 | sae | | ae =: as suiecineniineieinn | | 1ssaaeaseeeeenanee —_ J< {jf te a ssibiaes eel cceccenesiuitiaeiiel iininiatinAll te ; \- \- —__—] il ! | | = | (SSUES BY DORNTER CASKET CO. BOSTON, MAGS... 1816 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS \) Yearly No. 4 FOR THE FUNERAL OF Total to date Yearly No. _* ’ von tan bineenn. on Tota/ to date he ler fla ki de / - oe ®, Z ao A saci wag Ki nae hex ws “AL : 2€ ie 2 4 (yj / o s 4 Residence ete AK icklisias Movtnan, AO Lg 3 Place of Death 4. . 7 ” - etc ~'s : Place of Deat!, Miter Le : Wife or Widow of Date at Riv C= s t 87; od = one os Race : Date of Birth Certs o— is 7 f J Years Sex ALLE Color or Race NO 7 2 oe a 7 i a 4 Qg se O5L rr (Mogth) Day) (Year) | of. ih el a Date of Death oy od. a 19/9. Age Months 4 Single ae 2 iia sil iead eo,'7 19/7. Avee iis Single a Kilt : J " om ail 4 Month) Day (Year) | : br Maiden Name ; A ; — Maiden Name r : L Days Married “7 << Ay¥4_f 3 ais @ A : A Ce ~7 5 - , Birth-place ( | j <p a \ hs Occupation 3 B oe Birth-place KR @0 a 4 Occ upgtion Sty nin, *Tety Chass / or a os g . A ys_t oe A z j a : => oie Name of Fathes ) ag a [His Birthplace ../ os ars . Name of Father ~ ee, LLNS C2 al i 7 Soe Birth. -place Ko A-At-£ - ‘ Ve leg, r fe: atch i lana t/ .€2. _ ka. 4 ; AB / h Ue { 2 SP 2 c Maiden Name of )ic Cult ee Maiden Name of Mother“. (F-*7 AG d Lale _ Her Birth-place A/ne 42e ~ E Cause of Death— Primary Secondary Paice ct teak Sein j Secondary Certifying Physician ° eC Residence Certifying Physician... sf Residénce Place of Burial a (_t23-2-/ ne Zemetery iin ok ental ‘Lo oe, A 7, 16 ae a abe -metery ’ Ru ar 6ielic : Funeral Service at / ( a 6 Lot No. | Put in the Diagram one mark like t): Funeral Service at 4 Lot No. Put in the Diagram one mark like this , ‘ er | | for every Grave in it. And mark 1 fe | j for every Grave in it. And mark this Fume of Service / — : Burial with double dagger thus : j Tree oe ney a = , eee ‘ Burial with double dagger thus : t : . 7 : / 6 l { i [& Rinse | : e ie , Gg 3 ) Date of Interment mechon Designate site of monument thus: Cj} Date of Interment @O et / f Section 4 Designate site of monument thus: . . o. 4 Cs a ahah eee ; ogee soe oes a= Sa ea a ae ' ‘ A 9 £ | i wi Casket or Coffin No Vox td Ba ee CIC Candles | | Cbd wi Calin Me. AI 00 Pactlae | Size Made by | Gloves i } Size Made by Gloves i I] ; i Lining and Pillow Set No Bearers or Porters a, i| bia 1 Pill Set N Bearers or Porters i| . ’ " J ining and Pillow Set No.... Handl Hearse to MAeech acre) Srumarer Handl | Hearse to <OCE HM ap ed er —— ee | / SF andles Te | ; , oe 2 Me aoe S1- Plate | awa ee bas ) oh | Pinte | | Removal i , / || a i} | Outside Box or Vault Coaches / \| Outside Box or Vault {| i Coaches VT 10 2 a i surial Suit - J oe 3 les Burial Suit i| | Aa ae] | | | Slippers | Newspaper Notices i| Slippers | | Newspaper Notices I i | Embalming : QO | Embalming i Washing and Dressing Washing and Dressing || | | Shaving Shaving | | i Service | ™ Services i | a | | } Use of Chai Transportation Charges | Use of Chairs Transportation Charges | Church Charges Officiating Clergyman | ee Church Charges Officiating Clergyman a : | | ae a. ©°. Cemetery Charges Amount of Bill ae if SFA 8e Cemetery Charges | | Amount of Bill ¥ a ae? joo . AP oe | . . Pact. eam poe } Musi Goods Ordered by fi @ pean f Music | | Goods Ordered 2 = y, S 3 ; | 4 - 4 | | | - We } | ‘ a Mahe. Chn Flowers Bill Charged to LAAAGA2~ | Flowers Bill Charged to i Z DR. CR. DR. CR ooo Oz een ST eee caciel a oe Z ti 9 ( eke ee OVS | Se | 47 Yeo WH 113) Vo Aint of 4 S099 REL (3 | “zy Chee eaoc : ene ea rete ae : i | | ae os 7 : _ | | | | | | eas ais | | | | | | ij : | j i i ¢ | | pl | Loita od | | | | | | | | am 1SOUEO BY CORNTEE CASKET CO. BOSTON. Mass. 1016 ISSUED BY DORNTEE CASKET CO. BOSTON, MAGS., 1016 eer ees ee a eee tens -- | | | | 43 , RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS : Tota/ to date ; 4 Yearly No. 4 "op THE FUNERAL OF Yearly No. A FOR THE FUNERAL OF Tota/ to date WALA f t¢a” g ULL L464. teh th. Aho. ~ - ' ; M04 ‘ 5 < / y ¢ ‘ J oo : Ho AK S¥4LL 2? » ats A ; — 2 a v 4 Residence “ A, 4 atl Al a At As esi 2 / ; ‘? » . ys Hm re i q Place of Death P : Wife or Widow of i. (a i gti l Le Wife or Widow of ) AO? 4 2 f , : . ; ; j Date of Birth é ” Y Years -_ Color or Race Date of Birth bi t to nd f 3 Years [Sex .° ¢atta lt Color or Race Month , Day (Yea j ‘ . & | ” ~ - . aq } aa . Mo Day) Year ' f Ne ae J / ge < 5 gle y's ‘ ‘ 4 | m0 Date of Death (e h Day es \ge } Months Single ' Date of Death { é 7 / r 19/7 Ages Months Single -+-+~-7 “ . ¢ N Davs | Married i . Month) Day Yea: | Maiden Name f D A @ : wi iui ; Maiden Name L Days \ Married z x / “f+ 24 Z ( Ea be t ‘ A / c 4 é Birth-place / we - Occupation y “ . os ' Birth-place ( Q CAb t a ws Hf Occupation E ae VWYA LE Cee a Sty: 1: lip ALE AL2 / aff / * Name of Father ae wc His Bicth-place - (Axka — EG Name of Father A . CS 7. t i<{ His Birth-place _ ‘ ‘A Jace 74 C. Et ok f Moth Lhe ~4 Ble. Her Birth-place “?“#2¢ 2 ne Ze a Alf ¢ if & Maiden Name of Mother ——— Maiden Name of Mother. // “a1 /Lu { a Her Birth-place ““ co md ; ; y ' Cause of Death Primary Secondary Decne nf Cth Briard J AAKM (ular? Secondary R , aus c i ; me y ee: J é Certifving Physician Residence Cavities: Pineal ST rn. ¢ a ia Airrct f Scat Rains n F (id tt € ( er ( , Pl f RB Lét ‘emete : ' f ‘ > Place of Burial & LL J Cemete ry Sia sh ok Husial dl A 4A d. 4 Cemetery | 5 , ; L Gawistod lo , : ¥ : ; ‘ Funeral Service at Lot No. | Put in the Diagram one mark like Funeral Service at C Munet uc Lot No. Put in the Diagram one mark like this ‘ | | for every Grave in it. And mark ) | for every Grave in it. And mark this lin of Service yrave No. 7 . ro : f Y nares | . time ol , Grave N 4 Burial with double dagger thus lime of Service c T 4 Grave No 4 Burial with double dagger thus : t Date of ite ient Sectic | = s f/f ba | a Intermer tion | Designate site of monument thus 3 Date of Interment ( Cc a Section Designate site of monument thus: Cc] i.e ! L Casket or Cothn No PEA GLA hue tiaf AO "hire 4? zo Candles f Casket or Coffin No. rf ne é “arte A eA 5 om Candles Size Made } Gloves i g Gian Made by Gloves Lining and Pillow set N Bearers or Porters i t Lining and Pillow Set No.. Bearers or Porters ll || . 2 | é ; i] Pe ot Handles Hearse to i i Handles Hidenta te a . 2 } 5 i : | f i, ~o Plate Removal } Plate Removal ee vy “«idcflet ’ ; | / Outside Box or Vault Coaches Outside Box or Vault | Coaches } i Burial Suit Burial Suit | | Slippers Newspaper Notices Slippers New spaper Notices ie ae | Embalming ‘ Embalming ae j | Washing and Dressing | Washing and Dressing | Shaving Shaving ‘3 | | Poa | Servi ; Services Hi | T Use of | Transportation Charges Use of Chairs ransportation Charges | ‘ Church Charges Officiating Clergyman =, Church Charges | Officiating Clergyman | . _— | i : 7 7 * & Cemetery Charges Amount of Bill » Ch | IN= Cemetery Charges Amount of Bill | . een lw 4 A a : d t j | / / ‘ Music Goods Ordered by _/7 + Ye- OTererafry | } Music | Goods Ordered by ¢ MLUt fart Ld Flowers Bill Charged to te ne i Flowers Bill Charged to DR. WE CR. , DR. CR. —_— = aoe OK = aa sons = : : aor — 7 \ be | y j x { 4 ‘s i i / 4 \ {9 ea x perme are an rh; Le ita Ke Xe U | 7. jwool Cf j A 2 4 | i A intel : | | i < Ee N | 0 7 a 3 bb i] | | ss | J AY \ ~ was 1 / j ; i | | roe j ° ‘ 7 a | \r oe | | ” o e | — ee | ij | re * L ke 7 : {| - i \% \ \ o i | - \ My si \ JU r } ‘ | | F ~ \ ; | | i] | | . \ | a we | FI i ; | | : ' i | | H - i Bo i | | | = oe oe | |. || il nine oe ciraeiT cecal if I ' - ville iis a j an ; i —— —+{| ces i. | | j tl i | | | | | | | | | | | - ” | | ] elie Roe ee nen 1 — =| | oe i | | m {| { || —_—_-— - — me a : | | ee 8 os | a ag 2st Sa ‘ a Ale anodes | a | os ‘J | | be os | oy A 'S8UEO BY CORNTER CASKET co » BOSTON, Mase. tele ISSUED BY DORNTER CASKET CO. BOSTON, MASS. tote ee nee RECORD AND BILL OF ITEMS R THE WUNERAL OF f Yearly No. y 2 Residence — Place of Death Date of Birth Date of Death fonth Maiden Name Birth-place Name of Father 7 ih Maiden Name of Mother Uwe “ t : + Zo 19 Age es Day) (Year) G (eiem , ae’ 19 Dey , Cause of Death— Primary en x) nar fp tor Certifying Physic G ep ome Uy Place of Burial ESOT ON Funeral Service at lime of Service Date of Interment Cothn No ever Casket or ee (Year 1. oe ae Wife or Widow of Selo Years Sex Months 4 Single ? Occupation DoteaeSPh His Birth-place Her Birth-place —— Secondary Residence Lot No. | Grave No. Section She Of Candles Married fee inlaw 2lp, Tota/ to date Wah ana — Color or Race pho fh A-¢— Put in the Diagram one mark like (/ I for every Grave in it. And mark chi Burial with double dagger thus: j Designate site of monument thus: [ 7 Size Made by Gloves | Lining and Pillow Set No Bearers or Porters | H | | andles Hearse to \| Plate Removal I Outside Box or Vault . Coaches } Burial Suit Fo eal | i if Suppers Newspaper Notices | | Embalming | | Washing and Dre ssing | | Shaving i Services Use of Chair Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill ei uo rf Oo 7 sic . “ 7 ; f ; Musi Goods Ordered by Ze ee). Hawt Flowers Bill Charged to re ee ser i DR. | “ . i 4 CR. oh 1301 JO Merry Re ez, J log f-+3 >] 2) | as | + a a - yf { \ 4 Yi w | LOK t~QA/ (ALL dt 7 — i el Ase 1 - . i HK <a wd : 4 I Rie | ae : [ae + I Ble i 6)! i aa - | “— | cain i] | — a \ | } | } oe | ; Emi i | {} ie | : | si | | ss || I is j } | | a cd | | | | ' i 'SGUEO BY CORNTEE CASKET Co. BOSTON, Mags. lca i 3 45 “RECORD AND BILL OF ITEMS US Yearly No. — THE FUNERAL OF Tota/ to date Sr far: Tess FEA, —4 ey. a Le ig Lay, A1 LO le, /j hee Residence Place of Deat!i oie or (Month) (Day) Date of Birth Date of Death Maiden Nam de~- Birth- place Pi | a i a ba pfs. Lo lhe AM Name of Father Maiden Name of Mother Cause of Death — Primary Certifying Physician Place of Burial Funeral Service at A_@. re Wife or Widow of Color or Race 19 f Sf f Years Sex (Yedr) } 19 Age . Months 4 Single (Year | Days | Married Occupation a = “tLe His Birth-place Necbave L@ X©€@ : Her Birth-place ( Ye fe ek Cp Ae Secondary Residence Cemetery Lot No. Put in the Diagram one mark like this And mark this | for every Grave in it. rave No. sane ta Burial with double dagger thus: ft Time of Service J ’ Jate : Secti Date of Interment — | f Designate site of monument thus: CJ ay ) : i Casket or Coffin No. O\02 || Candles I i| Size Made by | Gloves I Lining and Pillow Set No... Bea ers or Ss / ij (ey ; . sche Handles Hearse 169, Reere ten, ¢ eee, | 7|\02 Plate Removal / i} | Outside Box or Vault Coaches I Burial Suit | i| Slippers | Newspaper Notices i Embalming eis: " > i | Bi | vA Washing and Dressing a {| i} ; “He. Shaving {| | Services | | i} | } Use of Chairs | rransportation Charges Church Charges | | Officiating Clergyman Cemetery Charges | | | Amount of Bill IS Oo Music | Goods Ordered by eh v> u | 1 j Flowers Rill Charged to | DR. CR. cmmununuin EE a (oon ts os os oe — Y Wad ] > : Ae dh Ss ¥ = I fi t 4 Od ae _| Zl \ Ce i: 1} | | | j | | | | | {| {| li | | j | | | | i| | a i H} | | } | | | | “ fd |-— i | } | | ' 1] j “al | H | | | | | iG Ragen nn a esncorsanearananan _ | || ~ —— - ! | | | : ie sits ae sisal | | — i— 5s us des | saiiuiaickaolinieimbdbcias SL | | | | z a iiieiata inne ane el enna | ae = csi Stell | | ! | | | ISSUED BY DORNTEE CASKET CO. BOSTON, MAGE... oe See oe: BT AAI sisi _, RECORD AND BILL OF ITEMS (. FOR THE FUNERAL OF Tota/ to date rs Jl ic 5 Kars a FY ery LR 3S? Laden 8-2. i} f-OLe 12 Wife or Widow of a ‘hg eae a Yearly No. Residence € Place of Death Date of Birth Color or Rac« fp Ov J/— G50 CoQ rea HK a4/ (Day) (Year [ y 191.-F “ Months ] Single onth (Day) \ (ese AY Days | Married Ae da-ce.d— oe Name of Father Ohiigse Wasenen Maiden Name of Mother a a Cause of Death— Primary ie Certifying Physician wy 2 A: MARrrk ra Place of Burial Qate CLI O-o Cemetery ‘I funeral Service at Oak Lot No. it YW os ~w 3 f{ (1G Date of Death Maiden Name Occ upation His Birth-place ea. sn. QO. Ae Her Birth-place PYCRL OL @es 2a Secondary Doss Birth-place Oo actnonstncnaasenpicensllfi ts ~—~ Kesidence Put in the Diagram one mark like " » , Grave in it. / ark ¢/ Cin Me. | for every Grave in it. And mar} Burial with double dagger thus Section 1Q0©/|00!| Candles | Time of Service Date of Interment Designate site of monument thus: ae i li rcarnatitstantsiaeaithitinunsiiias EE Casket or Coffin No Y Yearly No. Residence Place of Deat) Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Primary RECORD AND BILL OF ITEMS FOR THE FUNERAL OF ti Pirckk. aL, V Pelican he: : A~ Mhy 10 1% O Poy “" he: 19/4 Ay Yeah) Month) (Day) Tota/ to date W ife, or W idow of Color or Race “Bp OE Years Sex o FT. Months 4 : a iF ai. Days . ) a @ oe) ; Q j YcKLRL 4 Lo. Occupation Th m4 nn. His Birth-place 4d) G2 TF te. ete Her Birth-place AY ho / 4 Secondary Ys sof a Single Married fs + Y~€eQ G2 A& ssidence 9 Ly ie ieee ] VAL Lot No. Put in the Diagram one mark like this ‘ N | for every Grave in it. And mark this aan ore , Burial with double dagger thus; f anaes Designate site of monument thus: a 5000 Candles - Casket or Coflin No Size Made by Gloves } Lining and Pillow set No Bearers or Porters | * Handles Hearse to i 5e oO Plate Removal Sa Yrer 1 Ronse fey JO e | Outside Box or Vault Coaches / | Burial Suit | Slippers Newspaper Notices | | Embalming W ashing and Dressing i { Shaving | Paeereen 1 Use of Chair Church Charges Cemetery Charges Zo ©O Amount of Bill andl tinte ! 3ec OO Music G oods Orde re od ne (@ oe | | Flowers Bill Charged to Transportation Charges | Officiating Clergyman es Sa 1S8VEO BY DORNTEE CASKET CO, BOSTON, MASS. 1016 | " t = aaaiiiaiiiinaas Size Lining and Pillow Set No... Handles Plate Outside Box or Vault Surial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Made by | | Gloves Bearers or Porters Hearse to Removal i Coaches | Slo! it | Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill fp Goods Orderec py Lace | Bil OEE Neeg Yincrme| enti —————$—_—_——+ a Se r arian | | 1SBUEO BY CORNTER CASKET CO. BOSTON, waes. | 4 \ TN has a tc ata 4s : RECORD AND BILL OF ITEMS Vv FOR THE FUNERAL OF 0 oe © { Yearly No. Total to date 4 “Adel See: DOP? Cte Atlin’ fe 6 Kleecce Residence Wife or Widow of Place of Death “aoa” h ; a 3 G Po ao . Da Birt ite : re ia. Years Sex Color or Race Hin of Pieath mr 4 . IY Age Months 4 Single {~ Z 47 onth day (Year , : , ou Maiden Name L t Days . Married Ce Occupation His Birth-place KY* hee. & Her Birth-place EV theek G@ Secondary Residence Clebinkle AG Birth-place “D6 he | eC. Name of Father (9 rn ae Ae2_ fad ) Maiden Name of Mother o Mice, Cg . Cocech, Cause of Death— Primary t ’ & ¥ Certifying Physician { ue : Plate Removal fo “Pp Place of Burial Mee € go> C440 eh, Cemetery I il Service at Lot No. Put in the Diagram one mark like ¢); Time of Service Grave No. J ue Grave in it. And mark ¢/ - ; / urial with double dagger thus : Date of Interment Cry 1 ee (G Section ; ] [ Designate site of monument thus: [ ] Casket or Coffin No r Mars. ? \£.0.:| Candles | Size Made by Gloves | | Lining and Pillow Set No Bearers or Porters | | : f 1] Handles Hearse to i| I || | i | | | Outside Box or Vault Coaches Burial Suit S] “6 os Supper Newspaper Notices Embalming | Washing and Dressing Shaving Services Use of Chairs T i var Transportation Charges _ oh Charges i j hurch Charge Officiating Clergyman Amount of Bill Cemetery Charges Ausic Goods Ordered ”V j Fl . : . ower Bill Charged to DR. “ sepia — tn (G O Carer lee ee WO A ne ‘ Ce, =Z 2 J) Ld a | “i | | '88U80 BY CORNTEE Casket CO, BOSTON, masse. 1018 lla Aca aaasaieoneee o- a Yearly No. q 1 FOR THE FUNERAL OF Total to date / ‘ . j A Liklaiu CL Ce Me es Residence Ck) /) VA “&. Y ahe f ¢ Place of Deat!: te ‘Wife or Widow of | cm oe Date of Birth [LFV s , if 7 Y * Years Sex Color or Race . {_AMonth) aN Day) (Year) ae keh " Date of Death VAT s 0... 19f¢ mn Months 4 Single em Month) Day Your f Maiden Name L '.. Days Married 'Y% ALLS £ © AG Occupation AI otis (fits Birth-place QF Name of lather 42 4 ers Maiden Name of Mother Ah a Lhei feo t_k Cause of Death— Primary Certifying Physician Place of Burial C AK UWee (A ae C& £A.8 2 ba <” <2 ho rid c21.< fe His Birth-place Her Birth-place Secondary Residence ,4 Cemetery lio ; f or rere Se oe ee Funeral Service at ‘ f Lot No. Put in the Diagram one mark like this Mais - : Yn (i: £ (Fs se : or every Grave . And mark this ’ “ee: - Dh a FE #G | for every Grave init. / ss Se e \ / ] Grave rine at Darel ave No 4 Burial with double dagger thus; ¢ si ee Pe Sec Date of Interment on ] | Designate site of monument thus: C) 7 = 7 — Tr Hoe Baas = SSS = Casket or Coffin No. » 10a [CQ@\A ©' Candles Size Made by | Gloves Lining and Pillow Set No... Bearers or Porters i e * a, I a:) po Handles | Hearse to 7 ALL Vee a I J oO Plate Removal , i “ < rthauk Vahy 4 Outside Box or Vault } Coaches elites po i 1] “1,2 @ | | Burial Suit | Slippers _| Newspaper Notices ‘ R i | Embalming {| Opa | Washing and Dressing 7 / howd l \ | i i} \| | Shaving i ‘ i| | | Services 1} Use of Chairs | Transport tation ¢ harge s J ~ A Church Charges | ; Officiating Clergyman | ae i‘ * = , | Cemetery Charges — i} Amount of Bill x~2 | } j | (<4 ie. ; ‘ i Music Goods Ordered %Y (CHivae. Pol? bathosar Flowers Bill Charged to DR. hy woh sai sia vib iii iiiaiiiiaaaiiitlianai Nii i... Gesrf Of t/7 /*2 4... | ‘é { }} | : a -| at | | \ 3 ISSUEO BY DORNTEE CASKET CO, BOSTON, MAGS... 1016 49 50 . / Maiden Name of Mother Lf ck / Cause of Death Primary Certifying Physician , / f - } e Place of Burial K i li tAsbel Ay. Funeral Service at /f , kh Time of Service } y ‘ « f é f j Date of Interment a Sp — i Fg Ty Hl Casket or Coffin N KA LS //Ve_eo Her Birth-place Secondary Residence ¢ —t . A AA Cemetery Married RECORD AND BILL OF ITEMS Tota/ to date Sex Color or Race Single _ + 2 ‘ Lo 2 Ly Cn Fie Yearly No. | FOR THE FUNERAL OF Kathe a hui a ca Residence Cos chel ty Agsy Mer ite Goes —— Place of Death YY bee at Wife or Widow of é Cn Date of Birth [ ; / / , 19/ ~ Lf ars Years Jdonth 1 A~ Day) (Year) Date of Death ra ra 19/ Age 4 [€ Months Month Yay) (Year) ; Maiden Name : L 2 z. Days Birth-plac < cf x - pos Occupation | 6 ) ss ag ts a oe ¢ {7 Name of Father A/@¢b6<c7. “fC His Birth-place 2 %<Ke @€ Lot No. Grave No. Section Put in the Diagram one mark like t! | for every Grave in it. And mark this Burial with double dagger thus : eo ba t 4 5 eae Ah 10 0.9 Candles Designate site of monument thus: [ ] Size Made by Gloves i oe ren =n | i Lining and Pillow No | Bearers or Porters i} { Handles | Hearse to i ' | I Plate | Removal 1 || Outside Box or Vault Coaches {| Burial Suit | { Slippers Newspapei Notices | | Embalming | | ; | | i Washing and Dressing 4 | & Shaving | i ? } YErvices Use of Chair Transportation Charges Church Charge Officiating Clergyman Cemete aie ] ; ~ Co metery Charge Amount of Bill Je rc Music Goods Ordered by | Flowers Bill Charged to oe DR. CR 6 sg ypreeneeeeeneetemereeninmnieee — oenemeeeegecncmmeeees ory | a7 7 . Y/ . C4 Z J ‘ f . (¥ i / VM Cr A e_€A eh LCC | eee ee Sc a tn hin EO “ sil | | i | | | ’ | P | a | | | |. | | ; | ™ | | nciinnsiis | | i —— 1 oe — — { — { | . 4 } | | be | 1SS8UEO BY CORNTER CASKET co. BOSTON, MASS. e186 ¢ o1 RECORD AND BILL OF ITEMS AT Yearly No. FOR THE FUNERAL OF ‘ C04 doh Shi hkiin U “Wt bv Ltt A Place of Deat ( Keeere’d fb, Wits, or Widow of Date of Birth Chau MS bE ( ee va { Sex Date of Death i — i Age Months Single Month) Day (Year Maiden Name L st Married Birth-place “oh € LE GQ Occupation % dy a (+ - 4 Name of Father Vi: c Ra fa LM His Birth-place MEA LLL Maiden Name of Mother .¢ Yn i ck , (411111444 .@ Her Birth-place te Cause of Death Primary fe Secondary ¢ er > we / XA At. Certifying Physician ly y Place of Burial Funeral Service at Time of Service Date of Interment ( f a rv [ls Casket or Coflin No. Size Made by Lining and liitcow Set No.. Handles Plate Outside Box or Vault (Nets Nac Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery ¢ charges lee he i Jd -&wKesidence ét Babee ( ee (© - Cemetery | i ¢ ete Tota/ to date Color or Race a Ler € H— \ ed coef « i C4 AO Lot No. | Grave No. J Section Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: f Designate site of monument thus: 8 50 CC Candles Gloves Bearers or Porters / | Hearse to /e/¢, CM tee Removal Coaches J)C \y C Newspaper Notices lransportation Charges Officiating Clergyman | . Amount of Bill j | Mee Goods { Irdered by i | r | | Sf | Sa etl £4_ | Music | | ; Flowers Bill Charged to ; 2 bx L cen ee | ae DR. CR em f- une egg \ m “J rt "ey. er C v3 ee ( Yn (Sie LO Merk of Geli 7G OSA .AE/z 5 yViI.e § I R- {<). : 7 4 Z } | i] = | oe | i | i §1S8UEO BY DORNTEE CASKET CO. BOSTON, MASS... | seeaenieneenepeinneenat ne atte ma age ee ss aE, Yearly No. Crese 4 iia cd [}-- 442 - / Residence Place of Death Date of Birth ; Date of Death * | ay pig pp (Oey Maiden Name us eee Birth-place ‘yke re & A_@ Name of Father kee DA Of Q enn Maiden Name of Mother. /0VA@ /r.cec<ee_— Cause of Death Primary Certifying Physician’) VY + % | SAO ME erctee r At / ” Y [C fig Place of Burial Funeral Service at Time of Service Date of Interment Thav_2 — Widow of f OC Years . ' RECORD AND BILL OF ITEMS FOR THE FUNERAL OF } sun Veen Chie Total to date 19... | Sex Color or Rac¢ 19 ah Months 4 Single , é ays _ Married SY fl BL 2 Occupation Fy Urry t,o 00 His Birth-place Her Birth-place Secondary €o VE a LE Residence KL (sk Cov kOe Ae € AK Aa “Cemetery Lot No. Grave No. Section Put in the Diagram one mark like t! I for every Grave in it. And mark ¢/ Burial with double dagger thus : + re Designate site of monument thus: [ | Casket or Coffin N« 7 Candles Size Mace Gloves | Lining and Pillow Set No see ce ie | g Bearers or Porters | - | Handles | Hearse to i Plate | Removal } Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming | | Washing and Dressing | | Shaving | Services Use of Chairs Transportation Charges | Cuareh Charges Officiating Clergy man : : si 4 he 4 an ee en one Cemetery Charges Amount of Bill ee ay Age a | ) 0 of poe seowmemcgleneencana| sation Music Goods Ordered b oooh. the HH bere) Flowers Bill Charged to oR BRAS a me SS SSS SE ee = = = DR CR. (Sree nen Arsenate sneer oo ee SSS af . | Leech AL a | Che MY o | | Oe eee ee | | ae is eet, ae | i] | | | | I | | | | | E ial a | | - —— | | ih econo ——— _ satis 1 - “J —_ es Since | | a bs | ‘ ere emcee 8 : 'SSUED BY DORNTER CASKET Co. BOSTON, mass tere L Flowers 53 RECORD AND BILL OF ITEMS 4 Yearly No. FOR THE FUNERAL OF Tota/ to date Color or Race i / } fay TEASE “Teh kf ott : Z Residence l f & . eL4 é c+ <f ‘3 ¢ Place of Deat!: Wife or Widow of Date of Birth he) Years Sex Month Day (Year Date of Death 19 \ges Months § Single Month) Day Year | Maiden Name L Days | Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death—-Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. ! Time of Service Grave No 4 Date of Interment Section Put in the Diagram one mark like this { for every Grave in it. And mark this Burial with double dagger thus: f CA 122. Che Th we” ees Casket or Coffin No..... * Cecchi. KH Thiag ¢ LD Ce Candles Gloves Use of Chairs | Transportation ( harge s Designate site of monument thus: Cc) Size Made by | Lining and Villow Set No.. | Bearers or Porters ial Handles Hearse to Ya <ttexer, } PY core LI } ae Ic »¢ o La ° | i Plate Removal he cals | Outside Box or Vault Coaches | | Burial Suit | | Slippers | Newspaper Notices | Embalming | | Washing and Dressing | | | Shaving | Services i | I] | | | Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Goods Ordered by Music... | ; Och mn, DR. Fi egh | WV |\RRf oO Recta Aece /Ooloo | yrex4 J a 1 “| | es | | | ! i iF | " | "7 ay oe | | | | } i 1S8UED BY DORNTEE CASKET CO. BOSTON, MASS., tote 54 RECORD AND BILL OF ITEMS” wor THE FUNERAL OF eM (B-Ley : ecg he based A@ Le pb tt Yearly No. ’ hen ‘ wk Residen e Wife or Widow of 7 q Years Sex _-Months ~Days Place of Death often is HO a FT : f% e ae cr Month Day aN eLe — 7 ATF re Maldon" Meme / ee C _ ye kerk e A f Jherrk J VL, Date of Birth Single Married tha Date of Death Birth-place eae Name of Father His Birth-place Her Birth-place Seconidary........3.4.... p ¢ : econdary af , A @ Residence Maiden Name of Mother af ~/ Physic ian s C4 ta Cause of Death \Gebege. os esa. Certifying Place of Burial Tota/ to date Color or Race xk. Hace ks Put in the Diagram one mark like this And mark this Funeral Service at > t Aot’No. (2¢f; / eT a Time of Service - i E Oe Grave No, af / | for every Grave in it. A oe —-4 h /9 ' / Burial with double dagger thus : ¢ Date of Interment / Section. Designate site of monument thus: | ] arstnieiegnsecicisiiciiien a ate ee see Renee 3 Casket or Coffin No r (<a * Cay és Size Made by Gloves | Lining and Pillow Set No Bearers or Porters i ’ i] Handles Hearse to [hi chek I | Plate | Removal i Outside Box or Vault Coaches Burial Suit es Slippers Newspaper Notices Embalming W ashing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Cle yes a 4 . oy Le i m0 Cemetery Charypes Amount of Bill ak: Xt Le O.OC Music Goods Ordered by LO Ce» Wonca, i eae ; oe Flowers Bill Charged to [Lab ad CR. ae ee fh. 4 : /O1\0¢ eer HG | | “4 Ck Vous Ag rs | Joc AF ce val, | Ciimk 71 Vo 0 aot T a i ae 7 tee WG oo & ‘co ae iC naa é il schiaaan 4 ‘200; Se : ic eta : Li hoo ‘ (ekg | i} . | || i i poate | |. ——||- ; |- J | | Cd | | 'S8UGO BY OORNTEE CASKET Co. BOSTON, MASS. tele po napa N snensstvansiamiedt oe: RECORD AND BILL OF ITEMS Yearly No. J FOR THE FUNERAL OF Ae phe Gd”, — oT. shatrertie, A-.C- Pent es VY Ch 15 ‘ Resid Place of Death Date of Birth Wife or Widow of aim « pale Years Sex — Month (Day Date of Death at. Io > Months 4 Single Month) Day) Zz 22 iz _ Married whe te Maiden Name Days Occupation His Birth-place Birth-place Mens. acee~ P<Le ea Se ACU Sridue Ce —— Name of Father Maiden Name of Mother Medacceca Ja oe e_ Primary Meters Ct nec Cle a FP yo e // 2CLS - Grave No. —Her Birth-place Cause of Death Secondary Certifying Physician Residence Cemetery Lot No. | Place of Burial Funeral Service at Burial with dout nian iben ‘lime of Service Section Date of Interment Designate site of oct Exthe rihap . Weova a | i 3 i ky 73 re ) Casket or Coffin No. Candles Size Made by Gloves Lining and l’illow Set No.. Bearers or Porters Handles Hearse to Plate Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Tota/ to date | for every Grave le dagger thus: ft SS. Color or Race ltt; ~ Put in the Diagram one mark like this in it. And mark this monument thus: C] Services | | l se of Chairs lransportation ( harge s } | Church Charges Officiating Clergyman sal i | Cemetery Charges i | Amount of Bill } Vj\c° Music | | Goods Ordered by i j : are | Flowers Bill Charged to 4) 1, Seuutty | | DR. CR. WM Bo Hh aut 0 BLh | ASo. Alh/_ 340 Abe Cad k_ F100 } | oie ae — | j i dl | 1 | Se —|| || -- I =| { i "| } | | end | {| | | | | = | anal | | | i os ae ~=| | | a | | ] I! - | /——j]}-—— | x | | } | | | “I i ‘ aa y | = ee | | | | i : 1SSUEO BY OORNTEE CASKET CO, BOSTON, MASS., 1010 i | 4 56 RECORD f Yearly No. * tr Tt, CVALA / pis (Uhh Y Perce i Lf 2© Residence Place of Death Date of Birth Date of Death Month (Day) Maiden Name Birth-place Name of Father Maiden Name of Mother : oe Cause of Death— Primary Certifying Physician i { Place of Burial C Time of Service » O | Tm ’ ; ky ¢ b | f¢ i Date of Interment ep 5 a. (Day) Vann 19/9 [he D or @ “AS a Oaks (Ceres Cou ad“ Covent r Funeral Service at lt A e LL (Qeto | Dey go | ligt AND BILL OF ITEMS FOR THE FUNERAL OF Total to date ‘hetlee t © my va Widow of IF Years Sex Ag "9 a Months Married /“ ftted. | Cotesia abo Color or Race (Year) : hike Single His Birth-place Her Birth-place Secondary - Residence Cemetery J >. . . Lot Ne Put in the Diagram one mark like this | for every Grave in it. And mark thi Grave No. Sais Burial with double dagger thus ; + Lining and Pillow Burial Suit Slip; ers Outside Box or Vault a Sarton ; Designate site of monument thus: ee | | Casket or fi. “fa Nok rr Magee gad Gpake Candles | q Size Made by 10dy re 12 O PO Gloves Set No. 7 : | Bearers or Porters Handles : a Hearse to ye 7 | Plate ye fr Removal a ph © Coaches / <e a. | 1 oO 0 Newspaper Notices | : Embalming )( | ' ‘Wa | HA Washing and Dressing =. o/s | | Shaving | | Services | et | Use of Chaira Transportation Charges i Church Charges | Officiating Clergyman i Cemetery Charges t QvtLy\ ca. OO Amount of Bill / aq / 938 OO f Music Goods Ordered rs a& Y na | 7 } Flowers Bill Charged to OAL, OR | } = D j ' DR. cM 1 dn 5 Seen eee ean adden ae ae 1 ' ne = =x ~ ) beer, | iA Geek | a | : re 1SSUEO BY DORNTEE CASKET CO. BOSTON, MASS. 1010 ee Rortares lf bh ssescsastncin esos cae a cAI FOR THE FUNERAL OF Yearly No. Liateté €44 C4 4 C42 CL « ee Le UCL £ 7 Crk LY @Le4e 28 heat Ge A hay Ve (Year) Residence Place of Deat': Wife or Widow of Date of Birth Years Sex Date of Death © iV Age Months 4 Single (Month) (Day (Year) . Days Married Maiden Name x ‘ 7, a tn tke ©O 7. 2. ee a Birth-place wy fp Occupation - Name of Father Go Nee CALL €al A_S—— fis Birth- -place A (cA, &@ @ . reeleee G J ay f Eka Fee Her Birth-place Secondary Certifying Physician “ y SKM CLA rr > Residence el, Place of Burial I Cithete Beet Maiden Name of Mother Cause of Death— Primary Cc emetery es RECORD AND BILL OF ITEMS Se Lot No. Funeral Service at ay | ‘et miei Jo ae lime of Service if ad Grave No. i Us ty " Date of Interment te IT oa 7 Section J 7 eo, O° | andles KRtsn F Cel Size Made by ds vcee 2 Casket or Coffin No. Gloves Lining and Villow Set No... Bearers or Porters Ncorvce rhebleun, Handles / Plate (laf | Outside Box or Vault Hearse to Removal Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Officiating Clergyman Church Charges Cemetery Charges Amount of Bill . \ Goods Ordered by | CA e, ellen. p Tota/ to date Color or Race 4 oO <> Put in the Diagram one mark like this And mark this | for every Grave in it. Burial with double Designate site of monument thus: Cc) SA2V dagger thus: t Music ; lowers Bill Charged to hey, A i 0 a eee DR. CR. f PI eO | Bee {15 g @etre Aeee | i y leo A | | | | i | J | | \ 4 — 1 | ] a | | | | | eee | | | | Sea | | | oe | | i | | | | | ISSUED BY DORNTEE CASKET CO, BOSTON, MASS., 1916 Be f&, Ct ef 57 sr name ea ance ne ee es — — 58 Yearly No. fy ij Residence Date of Birth Date of Death Ks Maiden Name Birth-place Name of Father Maiden Name of Mother a tks. a i Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at J (Alia rh ky Ace Place of Death ‘A hLL oft Vauwley iw ek oe v* Bor Month) v pe o% ; a Cemetery ie + Lot No. RECORD AND BILL OF ITEMS FOR THE FUNERAL OF os ( Va Uther Met ‘ 5 (eol) Wife or Widow of a ST / Years = i (Day) ) - sa /. : 19) Age +—- _ Months Single nt day . jar) a J‘ L fi Days Married YX Occupation £Ah Ley — His Birth-place a 2 wf Oo fe _t/ er Birth-place a C4 1 hhe a> Le ondary ALA __ Residence bak c \ A & K LA -A_# ei Sex Nake/ Total to date Color or Race - OT rehLers2e Go Ye “ ee Put in the Diagram one mark like thi fs Weta of Garwina i A (icavn Nin | | for every Grave in it. And mark this Burial with double dagger thus : ¢ Date of Interment dhe Q- (N / 14 Section [ Designate site of monument thus: r epee cee = = soos pgp es Se ee il | Casket or Coffin No. a 2/0 © |, Candles | : i} Size Made by Gloves i| i Lining and Pillow Set No | Bearers or Porters | Handles Hearse to ie | 4 oaQ\o 2a Plate Removal ; | a || Outside Box or Vault Coaches hee Cole Burial Suit I Slippers an Newspaper Notices i 4 ; ) o Embalming ? | | Washing and Dressiny | | || Shaving | i | Services Use of Chairs Transportation Charges | ei | Church Charges Officiating Clergyman yi , MM ¥ ; ki ‘ ‘i . Cemetery Charges ‘noes [awk ( hee “eo SOC Amount of Bill —— | —___ Music Goods Ordered by A | Flowers Bill Charged to DR. | _ i a | | | pai | | i| | 1} | | | | | . | | } i ' ' ! | | pees | | | | | - 1 | | | | | dicaiahaill 198UEO BY DORNTER CASKET CO. BOSTON, MASS. 10106 Speer. 7 Detain «a RECORD AND BILL OF ITEMS Tota/ to date Yearly No. 7s a FOR THE FUNERAL OF “Mew Bea, V0ehore Were Prig ; <f . sae Residence Usst*o-—o— A ©_ \ f* fits. tlace of Death Wife or Widow of a Date of Birth O11 — | b ‘So | 7 ~/ Years ge Day (Yea uf Date of Death : [6 19 | Age ] Months (Day) (Yeaf) | Maiden Name ! a 8 { Days Birth-place (beeen a “A C Vac a roa cu, His Birth-place ér Birth-place Name of Father Maiden Name of Mother Cause of Death—Primary V Secondary Residence "7 es emetery Certifying Physician Place of Burial Sex Color or Race Single Married Ok 4) Oh Kae (at ha, Lkrty “oo = eens Joy [Qe AL eo anr_L£% ag ec od Ok. yvclew eek Jaceel, a No. Grave No hoe e Funeral Service at Time of Service Date of Interment Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ 18 / { 7 Section Designate site of monument thus: C) Casket or Coffin Now fhe Oa [OR Cea) J0010.0. Candies Size Made by. Cloves Lining and Pillow Set No... Bearers or P “— | Handles Hearse to Moen Ora | Jobo Plate Re move il | Outside Box or Vault | 2 Coaches | Burial Suit TO ce ee 7 J eC | fa _c_ (assets) V5 4 Slippers Newspaper Notices Embalming 7 Oo | Washing and Dressing | | ee | | | Use of Chairs lransportation Charges | Church Charges Officiating Clergyman Sa Cemetery Charges | Amount of Bill — I82t 5 s_ Music | I Goede Gedmed: ty rf for ere Flowers | | Bill Charged to DR. CR. nex aeeeapane pe pee i = eo ae Bie cae ay a hre)|1f /O Basnst df Perdis 26 ASS Kt. +O 4 CK _« Cf -VYOooe ba eff 1/4 ’ WS 3 YP 4 | I ed i : | | | Ea ee | 7 od ot a | : oe De pase | . ian a ‘| | -———----—— | a . |— cy staaee I. 7 be (Mriieititinil tap bd wc : | io) | | 1SSUEO BY DORNTEE CASKET CO. BOSTON, MARS... 1810 60 Yearly No. 60 Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician por Place of Burial IV Funeral Service at Time of Service Date of Interment a — - 1£4 9 Section RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Lhirk oe Wife or Widow of 157 : 6 Years (Yeary/af 199 Age 9 . J Months 4 Single ir) o J Days Occupation Her Birth-place Secondary Residence Cemetery a Married Mnheeuel His Birth-place hla ees, @ a @ @ GO Lot No. Grave No. Cc a or Coffin No Mh LC fih thd, 12$ 0 ?) Candles Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Senna SO a DR. Gloves Bearers or Porters Hearse to Removal oO Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by,, Bill Charged to Tota/ to date Color or Race Li trbs Put in the Diagram one mark like th | for every Grave in it. And mark thi Burial with double dagger thus : } Designate site of monument thus: [ ] } | oes Jo Fuad, | soOpe2 age fda e 1a2o CLL [Jot E .SL Grpy Sa Ree |1 4 Jo Meena h bund. 1S8UEO BY DORNTER CASKET CO. BOSTON, Mase. tere Yearly No. b / Residence Place of Deat!: Date of Birth Date of Death (Month) (Day) lo ‘30 Pn Year) Preheee Co 2.@.- Maiden Name Birth-place Name of Father a iL) Jae, Q). Maiden Name of Mother. Shei. Cause of Death— Primary PLe pe Certifying Physician Place of Burial Funeral Service at Time of Service Are Date of Interment Casket or Coffin No. Dh Fyesve Tabet THC oO Size teste, Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault ya oe 4 noel Burial Suit vous Nace Slippers [E-mbalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers eis CL Lot No. 2a hg Section 61 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to daie wm , Uakel - Ales 2 _— a. { Ly Years [Sex C7 fece (Day) Year) 4 1 & on Ay " Months 4 Single YL \ Wife or Widow of wee — Color or Race Days | Married Le le Occupation His Birth-place Her Birth-place Secondary 7) WR4y tRestdpaion .. be. Aba 0 hee dG h-O ¢tKefnetery Put in the Diagram one mark like this { for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: Cl] | Grave No. | Candles | |, Gloves | | >» \| Bearers or Porters | Hearse to | i i Removal i| \| | N75 | Coaches Hl Newspaper Notices | lransportation Charges Officiating Clergyman Amount of Bill | Goods Ordered by Log - es ts hse Ss namin ve Baill Charged to DR. dfs! ig Jo Ja. sued Geig CR. 1 621954 Mie ¥ Lt4 Zz Ca a > & LM ' { i | 14 | | | | “| - . “| i] i oe a | | j ' i | | | | | | | } | | 5 oe sec icsicaialealiiaes | ISSUED GY DORNTES CASKET CO.. BOSTON, MASS... 1010 63 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Yearly No. G “y Tota/ to date Yearly No. b 3 Total to date. . Ace. 1a ko ro Lee Place of Death ‘ Kaus hue ~~ ' De ae I4 — (Day Month Not € Residence AK <- Date of Birth Date of Death Maiden Name aa QO, nh LeuwAler. 2 Bi fr Birth-place Name of Father Maiden Name of Mother Cause of Death — Primary i ji Certifying Physician Place of Burial C.. i... (-.... 6 ... f Funeral Service at A Ch_ i Time of Service - (fs hin | hese TS ee a mae siete ae Cat ha or Wie dow of 19... "7 OYears Sex Cabse ae Bane 19 I {. Age Months 4 Single (Tear) rn q 7 Days Married © Occupation 7 toe 2 — His ai Her Birth-place Secondary Residence Cemetery Lot No. : Put in the Diagram one mark like this Crave No. | for every Grave in it. And mark this Burial with double dagger thus : Section Designate site of monument thus CJ ohare conn Casket or Coffin No Size Made hy Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flow ers DR. 5000 coat Chives | Bearers or Pores Hearse to .... Crete Reh / @.e8 Removal LX 1Zao @ o> o— £ Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill f ie A sf | Goods Ordered rsiflen t UMLAd [> o e Seen ———_—__—_——..., | Bill Charged to | ZB fd ie , 1S6UEO BY CORNTES CASKET CO. BOSTON, mass. tote j 4 7 OA 2 ty Residence (\tlatiaycee * Place of Death NV 4 221 4 Pain ot Binh PEL — Gav Date of Death ALL eP VO re 19/4) \ ‘Ka Maiden Name Moath) (Day) Pa,4'4 A espe wt rf a / Z Days c2 2 f Wife, or Widow of Years Months 4 Single Birth-place f- cheer Se * We- Occupation Chas f., Name of Father yew Neee, His Birth-place ¢ Maiden Name of ae k odd he Ste UCAL Som Her Birth- -place ty . Cause of Death— Primary Certifying Physician Place of Burial (¢ 2 OW dK. a Cemetery Funeral Service at Pirates 1a [x (Mien (Dir torneo. Time of Service oun tibiae € a Paw Grave No. { Date of Interment Qt4+3777 Section ws a hy ~ LY: ¢ LO Oererige (Residence Secondary a, { Sex Wale, Married (7 C- Color or Race lokite Ce “a? Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : f Designate site of monument thus: C) Casket or Coffin No. [Team Boal IT) 00 Size Made by Lining and Pillow Set No..... Handles Plate Outside Box or Vault } Burial Suit Slippers Embalming ya \e - Washing and Dressing i I | Shaving Services Use of Chairs Candles Gloves Bearers or Porters Hearse to 2 Dy aL — Removal Po eoo (12-0, 2, Coaches Newspape r Notices Transportation Charges Coo a4 Cams ‘ ad 1 ( : — Church Charges A : cre bien Dees Hora, | Officiating Clergyman | Cemetery Charges i 3 OO | Amount of Bill | | Music | | Goods Ordered by | Flowers | Bill Charged to DR. / | ae ] AY L nN vy ¢ Reeeb ,*€ 22 lé ai | ‘24 fies \ “| | a. fT a ’ nee | | | | J ol I - —— |— | 1 -— saneneeeneagenennnnnanmeemennnennnntem nan: | me = ics eecntnoied ic | | ISSUED BY DORNTEE CASKEY CO. BOSTON, MAGS., 1918 64 RECORD AND BILL OF ITEMS Yearly No. G y) Tota/ to dete Nh. ; / "rp & Eke, A \Ler12OtF Jtiuths, Co ‘KX AL Vittles v « Rha “A G FOR THE FUNERAL OF Residence a Place of Death Wife or Widow of ~Prsec sen. secerpeeneen eam ; Date of Death Z aah oF Age 2 Months 4 Single : Maiden Name es | Ft Married Y & Birth-place 226. -cupation oe Name of Father © fz Af / NVOQAMEAL His Birth-place | aft KO Maiden Name of Mother Cpr, dace Anta be A”. Her Birth- -place Cause of Death — Primary Secondary Certifying Physician Residence P lace of Burial Funeral Service at URice de Chew Ch ee. ¢ r 3} IG Cemetery Lot No. a s I for every Grave in it Time of Service Grave No. Color or Race lo-kit, Put in the Diagram one mark like this And mark this Burial with double dagger thus : i Size Made by | Lining and Pillow Set No Handles Bearers or Porters t Hearse to N fecre ean bowl, any : « TO Ck par bh Jf 7 Plate | Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming WV ashing and Dre ssing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery ( ith Music " i ae Flowers Amount of Bill yp #7 7 Goods Ordered by ~’ ¥* “+ Bill Charged to Ar ‘ | DR. i RE - re | | | By = tr . | | 198UEO BY DORNTEE CASKET CO. BOSTON. MASS. 116 as |. Hi arn a Date of Interment Section 7 Designate site of monument thus: 7 aces eeenann . - = emcees apiemen Casket or Coffin No Il OA Lo ©O\.O.C. Candles Gloves Seated ————-~ RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Cth: vue (eof «er. a Cheney TRINA? A. Ness 2e . Wife or Widow of a aoe °° oth (Day (Year) fs pure fhe 19/4 Ape 4 £ Months 4 Single J I f (Mon) a (Year) ‘ P Ce o ia Wek og i [ Days | Married Os Law = ‘d & { aw hg &! ) Wh -., Occupation “REAL t e be Met Ah eingy His Birth-place @ a. fa € ots.“ oe Ader Birth-place Cin Rog Secondary : = : , Certifying Physician @ & he. UG. +1222 kesidence [¥ (als. v clan X @ Gut va eh Ch eee los Yearly No. — Tota/ to date. Residence Place of De ath Date of Birth C4 vee A- Cerrale ar) ; a) © Years Sex Color or Race Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death—-Primary Place of Burial Cemetery Funeral Service at A cae OF Lot No. Put in the Diagram one mark like this sine “er C N ; 1 for every Grave in it. And mark this Hime of Serie A. “| oe , Burial with double dagger thus: f <e@ a Ff } ae | Date of Interment f / / —— | Designate site of monument thus: C) aan a ' " v 4 = | Candles i! — | Casket or Coffin No. Size Made by. Gloves Lining and Pillow Set No...... Bearers or Porters a Cv ° Handles | Hearse to Bath OoCw AaB | Plate } | Removal Outside Box or Vault ] § Coaches | Burial Suit | : pO || Slippers bas / ) } | Newspaper Notices | , iI | Embalming —p | | Washing and Dressing | | Shaving ] | Services | | | } Transportation Charges Use of Chairs || | Officiating Clergyman 6,4 & Church Charges | Cemetery Charges Amount of Bill ( Doe anes MIARL fy Music... Goods Ordered by Flowers | Bill Charged to DR. Mee Jaret eet) oS ool Oue 2] & S65 . - —— j 66 Yearly No. G ( vy Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Place of Burial Funeral Service at Fins of Gervien Date of Interment CE Casket or Coffin No Size Set No. Lining and Pillow Handles Plate Outside Box or Vault i Burial Suit Slippers Embalming I Washing Certifying mene > y RECORD AND BILL OF ITEMS wits tu po 414 € Lig, c FOR THE FUNERAL OF Tota/ to date. / ki re Q PEUd AAW ‘Le Ae siesta ¥7 tac Made by hE Cemetery Lot No. Grave No. Section Woo | Gloves Candles | Bearers or P orters Chk es ee Cha en Hearse to Removal Lp { Coaches Newspaper Notices Color or Race / , Wife or Widow of Nee / 19 | Ave Months 4 Single a yi N ake Lit Soi el Days ee PLEX y CHL t 4 (4p ‘ ni Occupation , 7 By Lu @ ML His Birth-place Price €e VQ OA IMA Her Birth-place Secondary a. Nath d y Residence Put in the Diagram one mark like this I for every Grave in it. Burial with double dagger thus : { And mark this Designate site of monument thus: ie reer meneame §S8UEO BY CDORNTEE CASKET co » BOBTON, MASS. i816 y and Dressing | i} j Shaving | ’ ; services i len | Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill call ‘ ( gov . | Music Goods Ordered by Bh /?) th Flowers Bill Charged to ae ge | DR. Cc R Gee ae. “0 eek We \\G 00) Went yd eC Bol | lac SAF ho | eee ot | Bees V.} | : e: T¢,, oir | | } aa! reais 2D | | —| Ges ee | Yearly No. G ’ 2 Residence fn Place of Deat!: AZ Date of Birth Lte.g ite oO irtn o fe Date of Death Maiden Name Birth-place ‘a re Name of Father ‘ ut Maiden Name of Mother (é Orv Cause of Death Primary Certifying Physician of Place of Burial “4 i Funeral Service at By Time of Service Date of Interment Casket or Coffin No. ha. > Size Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault Burial Suit A ete Slippers Embalming Washing and Dressing Shaving . Services Use of Chairs Church Charges Cemetery Charges Music Flowers Clee © « oe ce \ RECORD AND BILL OF ITEMS by & KL K_prw FOR THE FUNERAL OF he nhl Celellpaet be taw) C € ie 5 Ate (Day) IO th Day) / Ja Ake rch ele D ss td: A sete Suds Co J los GL (mni“ Wife or Widow of iG ° J q Years [> 19/9 3 Bs Months Single 4 il l 4) Y. Days | Married hLichatusf e Occupation ¢ 4 C4 hte ae te V Meo ve loo | | i | a 2. e His Birth-place o %2 sal caiditiaiasiite place Secondary ee Residence "ee 5 Cemetery Grave No. Section Co Candles Gloves Bearers or Porters Hearse to Removal Coaches * Newspaper Notices Amount of Bill Bill Charged to ‘ Transportation Charges Officiating Clergyman / 7 Goods Ordered byt@¢* «4 er 4 yeas 1 PpOLtva tC ¢ eo Co HE Yiepise & We oP Color or Race | for every Grave in it. Burial with double dagger thus: f Tota/ to date Put in the Diagram one mark like this And mark this Designate site of monument thus: . DR. ~- heer ~ i Y f my | j . | 1 | "| | | 7 | | w a i —_ ee | asa 1 - | i | et ss ss i HI | r ia a anal cue asin seseneeionensel onset | 188UED BY CORNTER CASKET CO. BOSTON, MAGES. tere 67 68 sey RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS Yearly No / FOR THE FUNERAL OF Tota/ to date Yearly No. FOR THE FUNERAL OF Tota/ to date. f ee Lh areat. Ahn. Tn AK Aor) a? G Residence £ Af MO f / /4 ty ee Residence Vit [AAG “he Place of Death a Wife or Widow of Nee f D f Birth r Place of Deat) .— Wife os idow of ale o irth 19 Years S . ; c : 2, ; : ; D Po pom ae Gms 25 jae . Race q Date of Birth i) € / 7 if 4 5 /... Years Sex ( lor or Race oe ong £ ‘ 19 4 Age Months ¢ Sing , (Month) (Dey) (Year) i I mn a o BAbha, tom , Ses . Date of Death __, Orie, 4 192O Ag Months 4 Single : Ath Maiden Name Days Married Y cy t 4 — iy (Dgy) (Year) 4 O i eal Birth-pl O / Maiden Name Bern C0 au Days | Married opener ccupation rs , Birth-place 0 hd Mu. DB Ke c Occupation ‘ Name of Father His Birth-place { ( hia ‘ eG ~ 2 . Name of Father eT thddss His Birth-place oo - Maiden Name of Mother Her Birth-place ott / : . Maiden Name of Mother 1g O~-t—.. Her Birth-place t Ls Cause of Death Primary , 4] if Secondary j ) A A 4 mek ck He ~~ (1k A @ Cause of Death— Primary, 4 Secondary si Certifying Physicia , = , y Pl . ; ; eg i A yD’ Se TH teas U, / Ase " € Certifying Physician y / - BessD Residence ¥ fate when a { ‘lace of Buria Ca ~ : Cemetery CL Vas UL = ¢ . es Shain eae (ORs Ob Place of Burial Y fe Ov fi £ AL a COhn Cemetery . A Lot No. - Ww : 7 /{ QALsw pes Put in the Diagram one mark like this Funeral Service at CG ht. Lot No. ! of Service { AS Put in the Diagram one mark like this — Grave No. | for every Grave in it. And mark this FRc Dies 4 * } 1 Se Burial with double dagger thus : i Time of Service 4) 2 © Le ofs a oe No. ics cue andes eae re 1 Destandte site of wonussent dh: oO - Date of Interment titty Section | Designate site of monument thus: [~~] sues a a Z ; : | a et or Cofhn No | . Candles | Casket or Coffin No. trparso 4922 OO Candles | Size Made by | Pl cas | Sine SB de be | Gloves | Lining and Pillow Set No | Bearers or “a CL u.@f | . Lining and Pillow Set No... || Bearers or Porters | — Hearse to = pee | | Handles | Hearse to Cf SG. : A. Plate Removal | } Plate I ' Removal Ale Leu vy C 7 aes Outside X OF il . | | itside Box Vault , Coaches iia a ei ie LO £4 a | || utside Box « : | ; Burial Suit 22 | SODo olippers | Newspaper Notices . | Slippees aS QIeb Sf 2 o/ | Newspaper Notices Embalming 2 : / Surial Suit Washing and Dressing Washing and Dressing <-> ree epee nee Shaving Shaving Services Services | | t} Z ; |! “mbalming | | | | | Use of Chairs | a. Transportation Charges Use of Chairs | Transportation Charges Church Charges Officiating Clergyman hea Church Charees \| | Officiating Clergyman ae Cemetery ( harges Amount of Bill AP f ME: c - C : Cemetery Charges | Amount of Bill 76 r = - Zh ne f Sahu f 2. Music Goods Ordered by we RArstrs T Music Goods Ordered by wy * Ka faoyd Flowers Bill Charged to Bes | Flowers Bill Charged to ix! ce DR. CR. DR. e Cr. Keg bb Jo Qrrs frie | Oopol. Tit LL, 1 Cm] rae Va. |7 Wo Gsuslete | 777 Jos) Sp jr.| 4 Heat | 7¢1 loo | | | | | ! | 1S8UED BY DORNTER CASKET CO.. BOSTON, MAGS.. TOTS 'S8URO BY CORNTER CasKer CO. BOSTON, Mass. 1818 rarer a Can Ree nn eee a rena nneel Serene e Preeres enna a ee at ee * 7 RECORD AND BILL OF ITEMS Yearly No. ( */ f FOR THE FUNERAL OF Tota/ to date { - any < MA La | (-, Oka ME, Residence : At Cow y Place of Death Wife or Widow of Date of Birth - f Years Sex Color or Racé Date of Death , Ages Months Single % ont | Maiden Name { Days Married j Birth-place Name of Father Maiden Name of Mother Cause of Death Primary ertifying Physician f ( Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coflin No Size Lining and Pillow Set N Handles Plate / Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressin Shaving Services bee Curcte Vaeeriy jh Occupation His Birth-place ? iL” oe" : he ; — é ~ 9 Her Birth-place < \ pr” Secondary Residence Cemetery Lot No. em Put in the Diagram one mark like this Ceara No. I for every Grave in it. And mark thi Burial with double dagger thus : ° .. Section Designate site of monument thus: [ } Candles Gloves Bearers or ve Hearse to hereto», } ont J Se Removal Coaches Newspaper Notices ldakts b+ \ (TRREn_ fs Vuc@Cc : te Use of Chairs Transportation Charges Bem Church ( harge s / sf Officiating Clergyman \ Ae 3 , my Cemetery Charges ¥ OU/Ga~ Amount of Bill fl , fee vas Music Y Goods Ordered by Orer [rw v “ra . + | Flower: Bill Charged to ¢ tg DR CR. . Aunehigspaicctlls pee — : peep Ana HL lo Qe hro2_| [oop oO “Tory 3! Sit. AY 100 co 1 | | i - al i| | i] i i w | | 1S8UEO BY OCORNTEE CASKET co + SBOBTON, mass. Yearly No. Residence Place of Deat!; Date of Birth Date of Death Maiden Name Birth-place Name of Father y Maiden Name of Mothe Cause of Death—-Primary Certifying Physician Place of Burial Funeral Service at Time of Service ba ges GER 71 RECORD AND BILL OF ITEMS FOR THE FUNERAL. OF Total to date Ok WW lUtste Oap [tata Un / (Month (Day) bor Co ne. , Ot 4 Y Slav a C24 AK Date of Interment ny ge Iq Size Made by Lining and Pillow Set No.. ' Handles Plate Outside Box or Vault Burial Suit Slippers embalming Washing and Dressing — iA init Shaving Services Use of Chairs | i | i] | | i | 1S / ( (Year) 194.0 Age | / Months (Year Casket or Coffin No. No odd Cloth, (Ry. lool OO! Candle Gloves Bearers or Porters Hearse to | 2 oO oO Removal | Coaches Newspaper Notices oo || | 5)0 & | | | | Wife or Widow of x 7r Qe Color or Race Single FP E-—Days | Married Of ex Ki, tf she chit Her Birth-place }..... Years « ; ‘OnRMe Occupation His Birth-place KLE €2 ef i Secondary Residence Cemetery Put in the Diagram one mark like this | for every Grave in it And mark this Grave No. Burial with double dagger thus : ¢ Section Designate site of monument thus: ss -nnnnscesmmlaa entnsiaiain, ae Transpor tation Charges Officiating ¢ lergyman Church Charges | ———_—_| —— Cemetery Charges | Jloo Amount of Bill € Jj 5 Oc Music | | Goods Ordered by, x¥ co Rt ‘ Flowers ! Bill Charged to -o ban SE Ci: DR. alta a“ _ 9 ee [dery| 4/20 JO Qeer fp (Ere AZe Bw fo, / 2fe0 | j ge — | | ra lt — ~-4 | ' “l = cd Sue F- wt MR BE ay —|- += 186UED BY DORNTEE CASKET CO. BOSTON. MASS... Tete ani . see eee cee eneaneentatane a agenin terribeemateemianicnes eet eet a ont ei eee RECORD AND BILL OF ITEMS Yearly No. UL MULL Wa oA v JA frail. AE k Oe Oe " eee /¢ nth Day) Residence Place of Death Date of Birth Date of Death Day Maiden Name Birth place A ee AY Ya © Name of Father tiden Name of Mother »of Death Primary ing Physician of Burial it Service at FOR THE FUNERAL OF Tota/ to date Stig “Bh kag IL hig W ife or Widow of 19 4 O Sex “AA BLK | Years Color or Race (Year / rch. (2 ey ee AD - Age | Months 4 Single C/ —O tL. Days Married Occupation 7 ¥~w*cL4¢ A ©) His Birth-place i. Mis Ck der rchir, Her Birth-place Secondary Kesidence Cemetery Lot No. Put in the Diagram one mark lik Grave Ne. I for every Grave in it. And mark Burial with double dagger thus Section Designate site of monument thus: [ ] Casket or Coffin } O1Ze Lining and Pillow Set Handles Plate Outside Box or Vault Burial Suit Slipper Embalming W ishing Shaving Rervins Use of Chair Church ¢ harges Cemetery Charges Music Fi ywers es ) DR | (pan? V6 Candles Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices lransportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to | | Ce | | | | (S880 BY DOANTEE CABKaT co » BORTON, MaSe. tee Yearly No. l. Residence Place of Deat!: Date of Birth 14 Grp basse he / KY es : (Month Day Ltt] >, $ Maiden Name re a >» - OXS 2 Birth-place Eg Name of Father } n eo a 4 fi Maiden Name of Mother/2 Ah a fy Cth Certifying Physician Fae Place of Burial teas _ af Funeral Service at eo Time of Service Date of Death Cause of Death — P a 1/0 Ah, Lees — ifr o Date of Interment tL (a fog [v0 Lot No. RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date i al ee ike Wife or Widow of 19 f Ws Years (Year) 19 2 O Age Months 4 Single = | Days Married ea. ese : Wehese (eo A v ba (hse ee, Sex ¢ * KR Color or Race Occupation His Birth-place Her Birth-place Secondary hy» ‘i Residence Mt rLie e We G Cemetery Put in the Diagram one mark like this 1 for every Grave in it. And mark this Burial with double dagger thus: ft Section | Z | Designate site of monument thus: C) Grave No. j Casket or Coffin No... 7 1 Lp40 ae Size Made by Lining and Pillow Set No.. Handles Plate Outside Box or Vault Burial Suit Of« A Slippers : embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Candles Gloves Bearers or Porters Hearne to Yeu Ny ew Meal Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill L4. 7 v {a Fixes! Goods Ordered by Bill ¢ harged to ES ERO A A ES / Rhu, | =a =e j | ISSUED BY OOFNTEE CASKET CO. BOSTON, MAGS, tote 7 ibaa MNS, Renta: 74 RECORD AND BILL OF ITEMS Yearly No. KBY Ven) Residence Un ih Llc 24s,leo Place of Death A itv uae A € Date of Birth \ \ Ww — i : Wife fee of FOR THE FUNERAL OF Tota/ to date fs re in 4 ) 1% 3 a/ Youn Sex ( ‘olor or Race j ey) (Year) Date of Death } 5 19“) O Age ‘VY __ Months Single . 1 (Day) Year) i aan me Maiden Name ) Days ieee ico | Birth-place QL — Qtr Qe _ + _ VW e. _-Oecupation Vii an. 4.4 Ce, i Name of Father LO» _P [Leeper His Birth-place 7 eae Bes, { Maiden Name of Mother Her Bi -plage Cause of Death Piinauen le (rn elcar~* VAY (ths aeeed Le. Certifying Physician Oy c SAL VAs edn Place of Burial L 4 W h LL) Zks a0- +0 Cemetery Funeral Service at Lot No. Put in the Diagram one mark like th Wine of Garvinn Crave No. | for every Grave in it. And mark ¢/ as : Burial with double dagger thu Date of Interment Qc. (Vv ya Section / Designate cite of monument thus . a3 ‘ Casket or Coffin No RO We Gee Vibe GO Candles | Size Made by hy - Gloves | } i} Lining and Pillow Set No | Bearers ters i + | ; 6 arc} i 4 A Handles Hearse t (oe Ceocrfia sto i} pS } | Plate Removal | Outside Box or \ uly 7 sa Coaches Burial Suit dtc 9 we eek. aes” / nn Slippers V 0 0 Ne wspaper Notices Embalming Washing and Dressing \| Shaving | Pervices | ” Use of Chairs Transportation Charges Church Charges Officiating Clergy man | a aS Cemetery Charges Amount of Bill / ¥ 7 Saas Music Goods Ordered by Novinss | } Flowers Bill Charged to a pf orl Brine ; DR. CR sodiiibihiia oe a 3 Ce U3) Vo Gann Bese, | 95/07 | Che ek Y I J Fra | Gok He ohao_| Che ical <n ame | / | | J L| ~= / 1SSUEO BY DORNTEE CASKET CO. BOSTON, Mage. 1018 Me RECORD AND BILL OF ITEMS 1 for every Grave in it. Tota/ to date Color or Race Put in the Diagram one mark like this And mark this Burial with double dagger thus : ¢ Designate site of monument thus: Cc) Yearly No. FOR THE FUNERAL OF - } dv Rue Shy Residence ; / . f J 0 ft . Mar ee : Place of Deat!: 4A Wife or Widow of Date of Birth 1Y f Years Sex (Month Day ~ (Year Date of Death LAtA/ L3rs 192 ¢ Age Months 4 Single Month) Day Year Maiden Name { Days | Married Birth-place G Occupation Name of Father CAB nines /J her Pr" MAiedtenTy His Birth-place Maiden Name of Mother Her Birth-place Cause of Death Primary Secondary Certifying Physician Residence Place of Burial ga d.g Cemetery aL f Funeral Service at aut Nt fret b= eas. € ttt Time of Service uG Pn. Grave No. J ) Date of Interment d ita. (of { "Lo Section , | 77 “Li LD ~ —_ — ae | oe cece © f = PT rr) a Casket or Coffin Nos Oo v Ka 5 / OG O°o Candles Size Mide by Gloves - Lining and Pillow Set No.. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges P ) Clie Charges vi of Ve Aan Music llowers DR renee heryieeeeesemns Bearers or Porters i“ CM He he tLe erft ¢ Hearse ise ach 4 Removal Coac hes “CEE Al a a Ne wspaper Notices | | j | | | i} | Pransport ition ( harge s | | Officiating Clergyman Vv joo Amount of Bill Bill Charged to * dn pa 1G ) etc kK CK£ Ee £ hewn Lk | wer ee | AMAA A Aa — 4 # ; CO Lett cd Wiha, Lf - Goods Ordered by¥A+4y Kaas ae ay cin eR eee snaennnnensstnenneasensl | | | } seein isinesnceniitacing Hh 4 A ie a er | | | ii 18GUEO BY OCOANTER CASKET CO. BOBTON, MAGE ' tere fh oe Ce. far Dl. r O eta pet rt em Nee ee a ae a ee Se ieee eae aokoweene semmecmam ae. eee ee Ce nen ee 76 RECORD AND BILL OF ITEMS Yearly No Y sg Residence Place of Death R 4 . q Date of Birth Date of Death Maiden Name yi Niels law Celie Vrarur Y Laver Cf KL chlor / fonth / es 10. ear a re ) ft PUP") KH i Birth-place Oc on Name of Father His Birth-place Maiden Name of Mother r Birth-place os THE FUNERAL OF Years Sex Months 4 Single if v. Days yj feelae ae. Total to date ‘ife or Widow of WAhe_ YK ( olor or Race ALik, _ Married mae. J A= Cause of Death— Primary . Secondary } ff { ‘ 4 “ Certifying Physician { 1 {A NALLL£Le. Residence Ae f fk ¢ Fi Place of Burial Ahi, Br. Chertlery f 7 Funeral Service at A AS 4 A Lot No. Time of Service Grave No. Date of Interment Section es IO mmensmey soos sap moore Casket or Coffin No (La {C4 t Vi Last Jf Oe Candles Put in the Diagram one mark like t) And mark ¢/ | | for every Grave in it. 1 Burial with double dagger thus : 7 Designate site of monument thus: ; ] | $j. | 1 chelate { | Size Made by Gloves Lining and Pillow Set No Bearers or Porters : # es } ~ Handles Hearse to (<8 \ a mmnaidha Plate Removal / Outside Box or Vault ‘ Coaches | Burial Suit - h | Slippers | Newspaper Notices ] Embalming | Washing and Dressing Shaving Services | * Use of Chairs Transportation Charges | Church Charges Officiating Clergyman Cemetery Charges Amount of Bill sgt } Musik Goods Ordered by M At C ({O-ve_f | , Flowers ori sia Bt vn Bill Charged t« Lbiies 5 Kale ia fj ). DOR : 2 CR. . es pn ¥ > igh — 4N14|_J2 0 a bi| gage fy t\ 2B ‘Goa ae | ) } } ! i ' } | | | | 1 amma uae —{ — — — il 1SSUEO BY DORNTER CASKET CO. BOSTON, Mase ie eeeneamseseaeicaeeameentsisbininen —! | | | - | } | | | 4 RECORD AND BILL OF ITEMS Yearly No. / A da b 4 Residence aca Place of Deat' NAA 22 7. * Ate. fen HAW Wife or Widow of / j Date of Birth 19 / Gg Years Sex Color or Race (Meath) (Day (Year) Date of Death Es 197 Age Months § Single (Month (Day (Year Maiden Name L Days Married ne , 0 Cel Birth-place /3 & Ms vii rll £ € Occupation ge ? / a f| : Vat ET, A Name of Father Ke Pe \. c. a_e+( His Birth-place MEP ET LA o & € V (ilo ekl G. Lee Maiden Name of Mother : rE tA Her Birth-place MheX hte o- CELL Cause of Death— Primary Place of Burial atte vLie Funeral Service at Time of Service Date of Interment (a Kir ovbhe FOR THE FUNERAL OF la @Xh ua 4 € C46 toric a. / U : ; eek Y A444 Yallaee 14 Secondary <4 0X ec AL if ’ Certifying Physician A J Ga a ax >< Residence Ext . # c€ Cemetery Lot No. | Grave No icscipcital nib Section | r Tota/ to date. Put in the Diagram one mark like this | for every Grave init. And mark this Burial with double dagger thus: t Designate site of monument thus: C) A di Casket or Coffin No. (Chek 4 V7 Size Made by Lining and Pillow Set No.. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flow ers Te vary Wh phing hop } 7 ls O aa ale aay § 5100 Cantios Gloves Bearers or Porters Hearse to Removal Coaches IM Ib Newspay r Notices ~~) S | | : : f lransportation Charges Officiating Clergyman Amount of Bill Goods Ordered by : y € he, la Cf( (Lae | DR. CR. aa ‘ - i - ous het 7 ¥; ” ~ t, N/10 | O Rent us ec Soa A r> 4 ee 1S6UEO BY OORNTEE CASKET CO. BOSTON, Mass, ae a NS ne penne Fs ee ee ene ere TS Sena ens Sa te 78 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF I VO Ate Vee. df : ef Le o-clae cok er il AL Shar. gh be Lod eh tec Qife or Widow of if 7 My Years Sex Yearly No. If Total to date Af eveeeen / Cree hl, Residence Place of Death Dh Date of Birth Mere Color or Race ( Month) Day) (Year) Date of Death f a / gG 19° O Age Months 4 Single (Monfh) (Day) (Year) ad Maiden Name | Days Married €¢+-@at<« Birth-place a AAA Ark At CL a Occupation . ¥heUK / RM te 4 a1 His Birth-place Minty : g ie 8 sa lb. LZ Her Birth-place Name of Father Maiden Name of Mother..--—— Cause of Death-— Primary Secondary ase Th ae ities Cee tetee de Be Lee hay o~ ~<, Ck CA Gemetery , Fw if Ce ak, Lot No. (A a Lh Zz Oo 2 © Ss : J z Section F ; ectic é | | 4 Place of Buriai Funeral Service at ; : é Put in the Diagram one mark like t} | for every Grave in it. And mark th Grave No. : Burial with double dagger thus : # Time of Service / Date of Interment Designate site of monument thus: [ ] Casket or Coffin No V Oi Ol Candies | Size Made by Gloves } Lining and Pillow Set No | Bearers or Porters SY i i / Handles Hearse to pane (Risrel~ | an to it Plate | Removal | Outside Box or Vault Coaches | - | Burial Suit ro a | Slippers Newspaper Notices | Embalming | Washing and Dressing | Shaving Services Use of Chairs Transportation Charges | | | Officiating Clergyman p= eisan j Church Charges Cemetery Charges Amount of Bill . ne eh Nae SO Cle he © WUiXa | Music Goods Ordered by — : AL \Raey ~ isn - Na } i ( / | Flowers Bill Charged to U4) Ww K a ahh. | DR. CR. } ‘> ° aia ; = 5 het > fle pod Vo @turtleee) (y5lo0\te2e | YA AAeksHe @| 19720 } se | i —- “| 7 y | . 1] j j | 1} | | (SSUES BY CORNTER CASKET CO. BOSTON, Mase. 1010 79 RECORD AND BILL OF ITEMS Kote ] ‘Hes » CLK Yearly No. / FOR THE FUNERAL OF Total to date ot _ fe ji Residence Place of Deat!: Wee 2 es Wife or Widow of j/ ™ Date of Birth Jnr - iF f oa Years Sex Coler or Race lonth) Day) (Year) s Date of Death fai lq 19%? Age ] Months 4 Single /] (Month Day (Year) Maiden Name . ) Days | Married haces / ; > fo - , / ‘ f . Ce f A. & Occupation , LL oy oe hee Ler La Cen (“R408 Inco aAhWE Bos <i Birth-place ¥ & Kee £ 7, _ e- de Pur “4A Her Birth-place oe Py Primary Secondary KN. /b4 w Wo sts Residence Cl, | : ern, j Birth-place Name of Father Maiden Name of Mother Cause of Death Certifying Physiciap Place of Burial Funeral Service at ly Put in the Diagram one mark like this | : ; for every Grave in it. And mark this Ti Service Grave No. | ! : lime of Service ( oe g Burial with double dagger thus : f 4 Be Section date orme Date of Interment Designate site of monument thus: a | ap we i Casket or Coffin No. tta I ©. Candles Size cesses Made by Gloves | Lining and Pillow Set No.. Bearers or Porters | Hearse to i Blioco Handles .... : Vy | sis [hat iposy y vo Removal Po Ro dy | ¢ par Callin, Oo Coaches U Outside Box or Vault Burial Suit \9 d Newspaper Notices V3 C/ il Embalming Slippers Washing and Dressing I | | Shaving 1 ae | Services | : | Use of Chairs | lransportation Charges Church Charges Officiating ¢ lergyman oe | a Amount of | f COCO Cemetery Charges Music Goods Ordered Sy | Pa ; } “lowers | Bill ¢ hare /, . Xen! Flowers bee Z 4 “0 Va gei-2Lrreg fg < AAA, One , , a eee = TS DR. Y CR. mM _ Jo Geuf Reg ee | leap eo Ack he EX hehe Toavte Ts oi pod oe | Zoe, "ph. || JV O02. _| | : es Lees i | F | | | | | | | | | a | 2 pos | | aa | | | | | | | i | | i ' } j 2 | J | | | | | | i a oe ee | a | I |__| | | | 3 | | | Re i ee a } | _ - —_ a - —|—____;-- Bs ae | a | | | | t { 1SSUEO BY OCORNTEE CASKET CO. BOSTON, MASS, 1910 Yearly No. / CATA, RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date gather Co gh; wucle, Ae Residence Hie Place of Death MAkee £ Wife or Widow of Date of Birth ey 1 A tha 5 19. f Years Sex Color or Race | Date of Death we ae 19170 Age Months 4 Single Maiden Name )/ = eS : : ai yi Days Married / Birth-place b/ HAL y¢ Ler a @ Occupation : ' Name of Father ¥ A>» fp Bek lis Birth-place Gye eb € 00 & ALC t | Maiden Name of Mother -— Q £ — f Wtty TEt.4u @AAHer Birth- -place a oe | : Cause of Death Primary Secondary : Certifying Physician ; Place of Burial \ al NLe CC cerer ter. Cemetery Funeral Service at Time of Service ichiiindetioieed Date of Interment ti 4 h Ogw ~¥ Ne hse. eh JOELL» / : / Lot No. Grave No. Put in the Diagram one mark like thi } for every Grave in it. And mark th Burial with double dagger thus: Section Designate site of monument thus: [ ] : Casket or Coffin No. V J ak i 7 7 20 Candles | Size Made by Gloves ] | fi Lining and Pillow Set No. Dearnes or Porters | i Handles Hearse to | 7 | ee Plate Removal | Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman | babies a “A Cemetery Charges Amount of Bill ct C L-.| Se Music Goods Ordered by —** “4+, 74k Flowers Bill Charged to We © erred) by } (c eT iae. = Sa ee Se a ge es Ss “Ree eee — otto DR. iii CR. Sess ( Our “ree, Jolo O|\U ay Oy | | eo | sah | Lil | | 1S6UEO BY COMNTER CASKET CO. BOSTON. MASS. 1018 A scammer aay a De RECORD AND BILL OF ITEMS FOR THE FUNERAL OF f , ae Pau .. Yearly No. / ¢ Tota/ to date < Residence 4 { IVC L Yo A CU le Wife or Widow of t r . lan v7) o A = A hk LA GAL, 19 7 Years Sex FWA if [ Date of Birth 0 bb wate Place of Deat': Color or Race / (Day) (Year Date of Death cfs 19 Age Months 4 Single Pie We ite of Death aay f Cf £ Bf ~) va, Ae onths ingle ( WA = Maiden Name i - Cee Davs Married ((!4aeu4 _ ; Os, Birth-place 1 0. £ his Co Occupation a A Name of Father RL ex A kicre £c/~ His Birth-place Maiden Name of Mother CKardglle. Ae Carnes Her Birth-place ‘ Secondary Vv Natee’ @ GA SM. @ Be Cause of Death—-Primary Certifying Physician b Residence Cemetery Place of Burial { Funeral Service at Lot No. | Put in the Diagram one mark like this iia wa ; . ' for every Grave in it. And mark thi: Time of Service Grave No. J ! - ; J < Burial with double dagger thus : } . : | Date of Interment f f vd Section Designate site of monument thus: a | 4 ; Casket or Coffin No. t f t aA Y¥2 ©O.C.) Candles Gloves Size Made by Bearers or Porters Lining and Pillow Set No. Handles bee . Core | vy loo Plate | Removal I | Outside Box or Vault re i 4 | Coaches | Burial Suit ge ' f ef ly ) | | | lOjeo Slippers j.-- |] Newspaper Notices | Embalming | | | Washing and Dressing | | | Shaving | Services H Use of Chairs | lransportation Charges | | Church Charges | Officiating Clergyman ae I | J @ On Cemetery Charges Amount of Bill Music | Goods Ordered by | | | Flowers Bill Charged to | DR. CR. iaiiininiie ho sae seniaenseveeioaiiihiiilaianias tains iiciemad ia _ = A {yo Ark ltece Y ac “ 7 ‘> owwA SO Po i : | - . | | | “i | | | | i | p 3 a 1} 1 ; \ ae j | i} Ter | | i] | j = =i : ne ee | \| ae a \ | | i | | — ISBUEO BY DORNTEE CASKET CO. BOSTON, MASS... 1018 8 2 oa Yearly No. /I TT Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father ro Maiden Name of Mother Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Ju fags - Primary RECORD AND BILL OF ITEMS FOR THE ae f OF le 2. pltle. < AC Wl a e422 m A List a, Wife or Widow of CLA of 19.4 oO | Years Sex Month (Day) a (Year os Bue 197% O Age Months 4 Single Mopth (Day) (Year) PLLA Days Married XV A AAAS a) 4 é Occupation en ‘ie . iv t- RU iret -place e —L Lk -? / LD. 77x WB eg Her Birth-place a“ ip @ rs Secondary : p “7 diesidenc € Ke ae C Agen “Cemetery ttle ict No. OE er Ne: +6, Grave No. 20 Tota/ to date Vy canter 4 LVrar 4a Ce A£ cy Color or Race Put in the Diagram one mark like this | for every Grave in it. Burial with double dagger thus: t And mark th ooceayflomcnns — 1S8UGO BY DORNTER CASKET CO. BOSTON, MASS. 1018 Date of Interment ... Section oo or Designate site of monument thus: CJ RRR la eee peceeepomeene Se eer a x Casket or Coffin No / / a “i he. / 2 00. Candles | Size Made by Gloves ] it Lining and Pillow Set No Bearers or Porters | f Handles Hearse to } i Plate Removal ii Outside Box or Vault Coaches } | Burial Suit i f Slippers | Newspaper Notices i Embalming | Washing and Dressing | Shaving | Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman ae Cemetery Charges Amount of Bill - ICO Music Goods Ordered by c .. /\4 ist Flowers Bill Charged to . ss DR. CR. et / “Oc Cn, | WIT th Diilne {Bic | ak | fA) V1) teteh\ bee =e Oster ininassticanicied RECORD AND BILL OF 83 iTEMS Yearly No. ne FOR THE FUNERAL OF _ Tota/ to date AH) Merto— S= ZL. OK ’ 7 nisl se / Place of Deat!: | cna Atlee Wife or Widow of Date of Birth of 77 Te) 2 ¢ Years f{ Sex ( Color or Race Date of Deat: : (Month) Fe th oink Birth-place Ings Primar iy Secondary Oy F i SKorek x —Kesicence Qeatesrap— A! Ceme tery inv? Age Months a Days | Maiden Name Occupation Birth-place Name of i Maiden Name of Mother Cause of Death ; oe Q Certifying Physician a Place of Burial Single Married His Birth-place Cte £Aes Co A@- Funeral Service at Lot No. Grave No. ry i : me | f Lee WY 4 Y Section Time of Service Date of Interment Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: | Casket or Coffin No. c (der / v ©° Candles Size Made by Gloves Lining and Pillow Set No. | Bearers or Porters Handles Hearse to Plate Removal Outside Box or Vault Coaches Burial Suit | Slippers | Newspaper Notices Embalming | | Washing and Dressing 5 6 Shaving Services Use of Chairs / | L . (oon | ‘hy 0 Toate [pete | | Officiating Clergyman Church Charges Cemetery Charges Amount of Bill ( Goods Ordered by Music Ball ¢ harged to eee ee Flowers Transportation Charges AF {haa | FP face o|— | DR. RERESROERE . . aenufenen j - f ‘ t +> } te Ly po JO aerk Gere | FSO he a4 i | | | ~" 1 | | | } ¥ 7 | | ad . z= | | 4 i | es os | il | i Ay fh ISSUED BY CORNTEE CAGKET CO, BOSTON, WASS.. 1918 Seanceeetie cate eee reeeerncn er Tn eee ere es Se ee eS er ee 84 RECORD AND BILL OF ITEMS FOR THE FUNERAL Total to date Yearly No. / 7 Residence Place of Death Date of Birth 5 . Month (Dey) a, Sex Color or Race Date of Death / 1970 A ge ~ i { Month —— V0 Put? *(Year) Months Single Maiden Name Days Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. 5 Put in the Diagram one mark like this Time of Service Grave No. | for every Grave in it. And mark this Burial with double dagger thus : Date of Interment Section 1 Designate site of monument thus: 4 eg: i || | Casket or Coffin No. Candles i| 4. ¢ ‘ Size Made by | Gloves i | i] Bearers or 77 \| Plate Removal Outside Box or Vault / Burial Suit Slippers Newspaper Notices Embalming Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Jp ? Amount of Bill 9 \ Oo Music Goods Ordered by wy Petdnd end. Flowers Bill Charged to nae yeeet Y | do Qeerh (ree Sao IC, Hao] Lo. 4 | 7GE | St i eee eenineeeleneneeeceee nae aa (SUED BY DORNTEE CASKET co. BOSTON Mass. e168 easiest nen Lining and Pillgw Set No. / (i Handles Na ble. 2 i Gey / Slee | Hearse to : + Hele 0 Pe love jt eee) [here /aiea Coaches Feehe (anal, | Ble. | Washing and Dressing / 7 vy) i| Shaving | HLecinig eee Plea by IF lez i | | | RECORD AND BILL OF ITEMS Yearly No. /§ a7 FOR JHE FUNERAL OF Tota/ to date (2. be kes J, Jasjlave yline 1. Residence tofe Place of Deat: / Wife or Widow of Date of Birth ae : 19 Years Sex Color or Race Date of Death a es ae Age Months Single Maiden Name Days | Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-piace Cause of Death— Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. | Put in the Diagram one mark like this Time of Service Grave No. } $ Sar oetry Sanue 58 Aud weet ti j Burial with double dagger thus : t date orme Section : : Date of Interment oe i] o Designate site of monument thus: Cc] | Casket or Coffin No. Candles Size Made by Gloves Lining and Pillow Set No.. | || Bearers or Porters Handles '| Hearse to | | Plate Removal Outside Box o I | Coaches Burial Suit oory ce oon JOpo i] Newspaper Notices Slippers J, % fp emer | ; dy Li Of ce im 3 E-mbalming Washing and Dréssing / Shaving i See | Services \| | | | Use of Chairs | Transportation Charges Church Charges | | ; Officiating Clergyman ea Cemetery Charges | Amount of Bill asl Music | | | Goods Ordered by | Flowers Bill Charged to CR. "Va @enk bike | Soleo AL 7/r0 oy, Caeea | Sobe DR. 4 Y | 1SBUEO BY DORNTER CASKET CO. BOSTON, MASS., 1018 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date, 4 Yearly No. “FO FOR THE FUNERAL OF Total to date phase Cute Woo A festa Teles aaane Yearly No. | Residence Veale, ia es Orphans Natero — ) c ~ ; P I rs . Residence aa Cotte ABE — “+ i lace of Death te ¢ Wife or Widow of ¢ Ce 2 aa we rer Date of Birth ‘ 19 / Vv Ss Aeale Place of Deat!: a - Wife or Qtor-ef ora hh he ain. BAA hh Arron ate o Years ex Color or Race Se Month (Day) (Year) 7 Date of Birtk 19 f Years Sex Chie @l « Coler or Race Date of Death . 1g... Age Months 4 Single fe WHike r wrens J Mbiuth) (Day) (Year y Qf ; : sa sia : rn Date of Death ig — 192 Age § Months 4 Single ek A er Maiden Name Days Mawiaa Month) (Day (Year) , Days | Married YLdI ‘ } ZG : Maide Ni e Birth-place /Ne Chhew bo (% Occupation ie Ov phan, iii faiden Nam A ‘ as ee 7 i ee OLla 5 il LLL ) a . : seis tde V% ha he Wise af Saihoy Litckica His Birth-place ly Birth-place ° B : Occ wpatibofe bf £ — Name of Father © a His Birth-place Maiden Name of Mother - ty Her Birth-place pene se sciaies : A ' pace aiden Name of Mother... C424 2-Ceece F, Her Birth-plac Crise of Death Pear Gaus dha. laoorcdk Cetond pa L— Maiden Name of Mother q hus er Birth-place / J £ v ) “ Cause of Death—-Primary Secondary Certifying Physician Residence 4 : Certifying Physician Residence Place of Burial Cemetery ee | is t bah Place of Burial Cemetery uneral Service a , At No. Put in the Diagram one mark like this F al Service Lot No i T Ser § for every Grave in i 1 uneral Service at Are a Put in the Diagram one mark like this o ee 2 , - . f « nark (/us . ime of Service Grave No. or every rave init. Andr h | iicnurGumiah. ke Burial with double dagger thus : Time of Service Grave No ad ; : Date of Interment Section Burial with double dagger thus : t e : Designate si , nia at intnan On \y? Sanad / esignate site of monument thu Lo Date of Interment \ Y \'Y Section Daclgnane shin ef enetienut Mia Cc Fa RL EE PES SEE SNOT Sapna te Oe } -s Casket or Cofhin No. ¢ AES (0 © Oo Candles | / : Z eee | ee ee 1] 5 Casket or Coffin No. to Bf /oooo Candles | Size Made by Sic | ce | Size Made by Gloves | | aning and Pillow Set No | Bearers or Porters | \| Handl | “fA , ; Lining and Pillow Set No.. Bearers or Porters i andles Hasan s Res a Ln | ee . ( Handles Hearse to / | 3 CoO Plate aide Xoo - Jelkn, ; Ke i : aH Plate Removal awe Oh nll 1s hen ff AV eo i i Outside Box or Vault Coaches i y ae fi . rene Outside Box or Vault i| ¥ te |}? 7 || Coache sa Ma. Neaerala— | | Jurial Suit i J O ; Cond I me Burial Suit Lolo or C BYR ua Ca. tics Meee | / Bico ol pers » ‘ ] . . | 1 PI wt Newspaper Notices ij i | | Slippers | Newspaper Notices “i 5 a) | PI | fe | Embalming 0 ¢ | Kibo i i |! Embalming | F | | } Washing and Dressing | | | } | Washing and Dressing i i Shaving | | i] | | Shaving 4........... / ; ; I | | 2e Ces - / | | i sbi “serv my) , dbo, . | / ” P e | ; j Use of Chairs Ta ninets as | AL QUE bh || i | : lair lransportation Charges r Use of Chairs | Transportation Charges Church Charges vitinh lores 1 ticcmraes | 1 Char; Officiating Clergyman ; oa Church Charges i] | | Officiating Clergyman | — Cemetery Charges ’ “PR: g ) i| | aa ' Amount of Bill J OO | Cemetery Charges | | Amount of Bill i a aft . music Goods Ordered by 4 ¥ CaO rNperut Musi | | Gevie Coben’ Caerie. Kofta: Yee 19QW9 § U4 £ ye fusic.. | Goods Ordered by Ca) Y L Flowers WO D7 Dy faake | | | wer Bill Charged to y ¥ A@evy aco | Bill Charged to ft t | ra senmnntenetinemnnteneens . a — VO Ve 3 CR. DR. Z ~) ie i. thn Ai mmm a ee == - a d <n soem = FOr fe C ) 3 7 * ae , pL i] ak 4 4 _|_v 0 @ersct AR KL GJjo oO MUR 2 Yeo kA _G-~ G@_ us Si4o JO QL LLPAVANG | 1G WI aT & eo. 4 / WAR - — | ee | ' / | hai + -|4 | | ro | ot a / | | | a | + | i} | i} | | 3 | } 4} a } | 1 | | : | ae a i i 5 | | | oo. | | | , } ! } | d | Seiad 7 | | | | ) | | | | | ee we ad 1S8UEO BY DORNTER CASKET CO, BOSTON, mass tere 1S8UED BY DOANTER CASKET CO. BOSTON. MASS., 1910 8S . RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS Yearly No. T Total to da P ! 7 a a or . Yearly No.) ; FOR THE FUNERAL OF Total to date Kym oes tov bale ee MV E.G. dak Residence Alrev nm Chey lo "tz Vs 7 Resid ds Wee Gir ae r,esidence — . Mace es ; ii se Place of Death Wife or Widow of i il eal, LZ Wife or Widow of date sirth 9 ‘ears ex . ic ’ 2 . . = Date of Birth wo Pa ] Pm Years Sex Color or Race Pinte of Bich 19 Veare iva Color or Race ate of Dee ‘ ca i ey) a | Date of Death Boos wn ] D Age Months Single ide ait teak 3 i92 O Age Months ¢ Single : ° Day) Year) Maiden Name Days Married i Mii. [ Days Married Birth-place Occupation irth-plac ecupatio Birth-place y Occupation Name of Fathes iis Risto place Name of Father ert Glhettctcteny jHis Birth- elias meen Penn et Meant ior Tetieglace Maiden Name of Mother7— LB Om ptt tata | Her Birth-place Chee eter Cc A no Cause of Death— Primary Secondary Cause of Death—-Primary ae UAB4tArAL A Secondary Certifying Physician Residence Carttieine Peale Residénce ‘er g Physicisz Place of Burial Cemetery Phase of Marat ie. Bo oo ry Funeral Service at Lot No. Put in the Diagram one mark like this Funeral Service at | (4 Lot No. | Put in the Diagram one mark like this Time of Service Grave No. I for every Grave in it. And mark shi aera - ce | for every Grave in it. And mark this sulle mca it ile Burial with dv ble dagger thus : lime of Service - Dw —— Grave No. ; Burial with double dagger thus : } Date of Interment Secti secti ) nen ection Disaigaaie vite of wicaument thus: CJ Date of Interment (s Section | Designate site of monument thus: es | ea as { 7 eT ne sa sean ig SE ; wi iL cnet en A em sas ~ as P wr , o ‘« ae | . , > {| Casket or Coffin N Candle Casketor Coffin No: Candles | Size Made by Gloves i Size Made by i Gloves i | ] a 7 on | . > | ‘a | F a Hi See ee ree Get Tee | Bearers or Forters ( Ya ee eae “| t Lining and Villow Set No.... || Bearers or Por »Ts | i Handles | Hearse to meet a - Handle Hearse to Cat ety + rf | f 4 3 | i Plate Removal i V ~ P60 Plate Removal _/ si J ey WE Prony I B510 g i é iI Hf ‘ a 2 | il 1 Outside Box or Vault Coaches Sree, ave cesliy } Outside Box or Vault i | Coaches H Burial Suit Burial Suit | Slippers Newspaper Notices | Slippers Newspaper Notices ; I} Embalming I Embalming | Washing and Dressin, ; WA Ut tA L v | / ¢ : Washing and Dressing | | | Shaving | Shaving | : Ciewi cn | 4 Services i| Use of Chairs Transportation Charges { Use of Chairs i| Transportation Charges Church Charges Officiating Clergyman : Church Charges I | Officiating Clergyman — : s ; | | s ) oO Cieaiiey Chane ome. 3 2, Ro Cemetery Charges ] | Amountof Bill A . PS ts Yjo°o | , i| | ‘ Music | Goods Orde Te ~d by R ™M CLeoe 7 | Music i | Goods Ordered by MEA na, os | | , | | | | ‘\ Flowers Bill Charged to 3 ue Flowers Bill Charged to | sb \ Qe . . > & } | + | | i ba 1S8UEO BY CORNTEE CASKET CO. BOSTON, MASS. tele i | i | 188UEO BY OCORNTEE CASKET CO.. BOSTON, MARS., ¥ RECORD AND BILL OF ITEMS | RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date teseue Grow Cena / Yearly No. 77 FOR THE FUNERAL OF Total to date Vy cha Pn ak Yearly No. i a ; Residence 4 Aer ARQe— Gay Re aalicioliidis | j a ; } € ( ce | j ~ a | J | Residence Sth Gry ¥ A~A_ Eee ‘ ; Place of Death Wife gr Widow of ; Date of Birtl \ f 7 rad y aaa, Place of Deat!: Wife or Widow of j 3 ale o irth ) | ‘ears Sex : a : ; | -7 A 4 4 Sdonth Day (Year Color or Race | Date of Birth 19 f iE p a { Sew “<<< f Cytor or Race i i Date of Death 19 Age Months 4 Single ~ + Fee © (Day (Year | ; 7 f d j — mer (Senn) - | Date of Death ee A 19D Ages Months 5 Single bo fh 4 § Maiden Name Days | Married fu heir Month (Dey) ma | E i ; : Maiden Name a. i Days | Married : Birth-place Occupation f f ; Birth-place Occupation re ef Name of Father His Birth-place , ; 1 Name of Father His Birth-place ; f Maiden Name of Mother. . Her Birth-place i ¢ 2 diane. Maiden Name of Mother Her Birth-place | Cause of Death Primary Oy a . y Secondary ‘ ° ; | Cause of Death—- Primary Certifying Physician dv ye eri Residenc MhnyertasteC _ | ss naeai ) Certifying Physician Residence it i 7r f { | Place of Burial Karwd . Cetnetery 4 ( yy 2 lar b f FE | +t tebe © 2 / f | Place of Burial . Stet... aw - “ ery iy uneral Service at * eA o1 No } f kd i eae Put in the Diagram one mark like this Fu al Service YZ ‘ I N : i / ; or = - neral Service at ¢ At No. P the D » k like this i Time of Service oO ef es ec. “ Cuave | for every Grave in it. And mark thi , fs Ul in the LAgTaM ONS MATE HES Coe ia { yrave No. ; ‘ for every Grave in it And mark this i . : LV. Mv. We J > 5 ¢ Burial with double dagger thus | lime of Service / Grave No. } Tcstel asich double dauiac teat e H Date of Interment 7 Kh / = Section | . 2 ; . 7 ak. (o “3-0 S } = ] Designate site of monument thu : ] Date of Interment : / Section | Disslisnicas cite of mniniaiak Mail Cc nap ae | i Fe ee ee — . = - / sptooseileonianildnabecisiiose dice stideialiameiiiineiciaies AIOE SET A Sa Casket or Coffin No Candles Casket or Coffin No. Candles Size Made by Gloves ; i Lining and Pillow Set N ) | tive Marte by Gloves i e' core Bearers eee js | i. Lining and Pillow Set No... Bearers or Porters “ x ae i} i Handles | Hearse to, eT ey ae | DO Co Handles | Heaven ty (LORS 7, Me. GL. Ge, | f Soo H } rats | Removal = - | | Plate Removal cr — 1 << i ; | ee ee Coscnes a Cera 1 te ‘nese Outside Box or Vault Coaches a Burial Suit i \| | ai | Burial Suit } | | Slippers Newspaper Notices I Slippers Newspaper Notices | | i] Washing and Dressing 3 7 wit acicsneneaiacn =" Washing and Dressing Shaving | i : Shaving i Embalming = />) \} 3 ; | i | fbn ov, (tha > | 4h7- Embalming ] Services | Services 4. Use of Chairs Transportation Charges Use of Chairs | | Transportation Charges Church Charges Officiating Clergyman Church Charges Officiating Clergyman | —e Cemetery Charee nha : 7 emetery Charges Amount of Bill Cr) ; 2, Cemetery Charges \| | Amount of Bill ~~ , } —fae&e Music 1 y Goods Ordered \¥ ‘ anne {CK ef r. } Music | Goods Ordered by - _ a ABs Flowers ll ) Oloo Bill Charged t@ ; ; isl’ 1} Flowers Bill Charged to - ieee oe a , | a DR. CR. CR. |’ Jo Drert eee VIG 7m Fa Lx Ohe 3 | Jo | *L | Cee | } Satis : ner : we y ¥ A | 2 (< | & Yv | | 4 vw) & Zo —< 4 | 10 oO | — } i 7 aS | : | 1 —— ee 7, Cte a a * ey — i} | t | | } / iH - } { i} 1| - — { -- - f «| — : ; | | | = | | oo | | | | saa | 4 “| 1| | i] | | ; | | | | | 1] i] | ! | i} i 1) i “| | | | | i || {| ] = bas 1 | ~ | } j ij | : | j 7 } j a } —_ } i | | | _|| ES. | | - ae | | iI | | j | j “4 eee | i} } | | | | | | | | ; | Bs | j | | i —|— 1 moon i | \ a al — - —__o | | — | - cd a | | | | i | | i | | 4 188UEO BY CORNTER CASKET CO. BOSTON MASS. tote 4 (8SUED BY OCORNTEE CASKET CO... BORTO: aoe ROSTON, MASS., 1910 Yearly No. “V Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Certifying Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coftin No Size Lining and Pillow Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressin Shaving Services rr Use of Chairs Church Charges » I riviary Physician RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Li hissgTan koesh O71 eet A hee gTe Coes ey: eo tae. 0 Tota/ to date Wife or Widow of Mabe y 2 a as 19. Years Sex Color or Ra Vel oy L J i ( ; - 19 ZO Age Months 4 Single 7D) Bs Mon Day Year — - Days Occupation Gag Married His Birth-place Hyer Birth-place f “4 ca 4 a, oe nt, Residence Cemetery Lot No. | ici ; Put in the Diagram one mark like this No. I for every Grave in it. And mark this Grave Burial with double dagger thus : + Section Designate site of monument thus: [ ] soncowet ere Candles Made hy Gloves i] | | Set No Bearers or Porters Ya lees ~ To Ctenset. | a | Hearse to i| QO Removal O Coaches Fy G Newspaper Notices Ken pe OuUe ~Tr hig <2Gf we Pcie ts Soo Oe Ch get Officiating Clergyman | Transportation Charges . a Oe eae ae Cemetery Charges ViO Amount of Bill | = ss F cS Music Goods Ordered by Akkhey OV 2 Chemety Flowers Bill Charged to {zt rs DR. 7 . 7 canine cite . 5 | d [ i bain | . () nit} i) ; Ih ai 5 \ ' rive Ayla | LL gawk NAA 1} 7 1 OC } 4) Vib Wa NUK aw Mae/ | Li _ | i | | “| i|- | | oS _| | | | a | | | |-~- = | | } | | | ——- - | J iis _ sain ; Sa sie i | | | | | | | | | | '86UE0 BY OCORNTER CASKET CO BOSTON, MASS. te18 L RECORD AND BILL OF ITEMS FOR THE FUNERAL OF C , Total to date Wife or Widow of Yearly No. Residence Place of De Mii Date of Birth Color or Race Date of Death hs 4 ‘Oo Maiden Name Days . Married f Years i Year fe © aa Months 4 Single { Occupation His Birth-place Birth-place Name of Father Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician Residence Cemetery Place of Burial Funeral Service at Lot No. | Put in the Diagram one mark like this Ti ts ; Cron Ma | for every Gowve in it. And mark this 3 ervice ave No. ime of Service srave ; Burial with doubte dagger thus: ¢ Date of Interment ve Designate site of monument thus: ae Pai / Doo Candles Casket or Coffin No....V Gioves Size Made by Lining and Pillow Set No... : ss as Handles Hearse to q. <9 Plate Removal | } | | i } j Bearers or Porters | | | Coaches | Outside Box or Vault Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Services a Use of Chairs Transportation Charges Church Charges Officiating Clergyman 7 Bloe Cemetery Charges Amount of Bill Music Goods Ordered by Flowers Bill Charged to DR. i CR. “ it afm * p= HKG | 4 2 b 7 ++ | Vile [lap Ph Baa ten| ele Dh ee f j “t | 1 ’ | | i | | || = | | | i | - | 7 } | ; | | | = | | | ee oe ee } | biceil = | | 4 | ci Saiasadlc clon dae oteigcciie “ ee | | Ri aa bad | ISSUED BY DORNTER CASKET CO, BOSTON. MASS.. 1018 94 ~> aie Yearly No. Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Cause of Death Se ae ea rr Sa a Certifying Physician Place of Burial Funeral Service at 7 ime of Service Date of Interment Casket or Coflin No Size Lining and Pillow Handles Plate | ! Outside Box or Vault na ie | Burial Suit Slippers Services Use of Chairs Church Charges . Cemetery Charges Maiden Name of Mother Primary VY (> By Made by : Embalming im |i a ; Washing and Dressing i | ‘ Shaving a RECORD AND BILL OF ITEMS K Cv z N & ein. " Ly IE— pee Day) = 5" Mghy &. ne, Qtek \Ase2ny yore ae ec Nase — 2 Pry. set No / ] —e ohe en Aha pre a Le pak, \ 4 /2 ¢ Section 150 C.G. Candles FOR THE FUNERAL OF _ Wife or,Widow of Bos Se (Year 19 FO Age Y Months 4 Single (Year) - >} Years Occupation Sates. 4 His Birth-place NMG ER, h-place Se de Me aly, (fal Lago Coe seb fe metery Days farried Ze Tota/ to date. sex Mave Color or Race / lex ek a o>. Aeaer/ ABGQon Ar. a / Lot No. Grave No. Put in the Diagram one mark Jike this I for every Grave in it. And mark this Burial with double dagger thus | Gloves Bearers or Porters Hearse to Removal ( “on re \ if Newspaper Notices Lb Transportation Charges Officiating Clergyman Amount of Bill Designate site of monument thus: [ ] 7) 7 fo iC Music Goods Ordered by // Ut © VOTE a es Flowers Bill Charged to hr “CHa, | 1 DR. . 4 a. ¥ | cae CR. (\ UX “Y JO (R222 WD 6&2 y . | {WS _JO es eek 114 00 AM hd IL Ce kT aaeo | | | | ges}- = | 7" g | | | | ~ | | — | | | | L—+—_] mer | | | 1S6UEO GY CORNTEE CASKET CO. BOSTON, mage. 'e1e RECORD AND BILL OF ITEMS Yearly No. ? § Residence... Place of Deat! Date of Birth (Mooth (Day) Date of Death (Month) Day Maiden Name Birth-place { Name of Father : i Maiden Name of Mother Cause of Death-—Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size oe Made by Lining and Pillow Set No..... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers pa! Sp FOR THE FUNERAL OF ——_ Mupero Wife or Widow of 19 (Year) 19 Age 4 (Year) Months § Single l Days Occupation His Birth-place Her Birth-place Secondary Residence Cemetery [ 2 O Years Sex ha 2».— Lot No. Grave No. ; Section | [oe Candles Gloves Bearers or P. osters Hearse to Remov al / Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Qf ( LA Goods Ordered by / tf | ce Pa | Bill ¢ charged to Tota/ to date a 5 2 Race Put in the Diagram one mark uke this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate site of monument thus: cs loo wy & 8) } | | | | | | | | | | | } 1 | | t ||—____—— Dr. ae re a. ’ Wad taf, © BSbo-. 20) 7E€~) Cased | i “| stillet eliiesieetiliniahi | ~ | Saad Poa | ee ced | | 7 | ) ———- \ 1SSUEO BY DORNTEE CASKET CO. BOSTON, MASS., t8Te 96 A 97 0 | RECORD AND BILL OF ITEMS : Yearly No. FOR THE FUNERAL OF Total to date ! y tee Us , r Yearly No. . FOR THE FUNERAL OF 0 @ . : LY Ornee /J2e20 we, “4) . , f 4 : 7 shay | Wi Koti A Walk wy, ev es Wacken... ) - Residence f : 4 ' Residence i ; Place of Death Wife or Widow of oe 2 a : ; ; Place of Deat!: Wife or Widow of ' Date of Birth 19 Years S . | j ; ° Month (Day) (Year et “a Color or Race Date of Birth 19 Years Sex f Color or h. ce ' t Date of Death 19 Age Months ¢ Single y (Month (Day) (Year) : } Mons (Day) (Year) ’ | oa en Date of Death 19 Age Months § Single Maiden Name Days Married Month) (Day (Year j ‘ ™ ee Maiden Name L Days ( Married a Birth-place Sone NM, Occupation if ll Birth-place Occupation j Name of Father ‘oe His Birth-piace ¥ ee | e Name of Father His Birth-place ' ; Maiden Name of Mother 4 ~ Her Birth-place s = Maiden Name of Mother Her Birth-place Cause of Death— Primary | : Secondary . | : , Cause of Death—-Primary Secondary 1 Certifying Physician eof s Residence | eee Certifying Physician Residence i Place of Burial f Cemetery ; : F - Place of Burial Cemetery HI neral Service at Lot No. ; ; : : { i ' Put in the Diagram one mark like this Funeral Service at Lot No. Put in the Diagram one mark like this : Time of Service : Grave No I for every Grave in it. And mark this is sates : | § for every Graveinit. And mark this Hl Burial with double dagger thus : j Time of Service Grave No ‘ Burial with double dagger thus: t | Date of Interment Section 5 HH Designat : site of monument thus: 3 Date of Interment Section Deshenate che of mentninnes Cen Cl Ei 4 Casket or Coffin No 6 ak At Oe Rae toLie .| Candles | t ne / a4 Toowo : oe / BAC) | y Casket or Coffin No. Candles Size Made by Gloves Size Made hy || Gloves I Rn re : shnsinieaneeeens | | i yy ( illow Se : . . | Lining and Pillov t No | Bearers or Porters ( | r Lining and Pillow Set No.. | Bearers or Porters {| Handles arse Ha “ ( | : 1 an Hearse to nana nn | ae | Hiacee to | : Plate | Removal ! Plate | Removal {} eat : | \| | i | Outside Box or Vault | Coaches | Outside Box or Vault | Coaches i 4 : ls i} > ) } Burial Suit } I 0 Burial Suit ra D Kc 0 Slippers Newspaper Notices Slippers | Newspaper Notices / i | | | | I q bi Ir y | | | a) mbalming | | Embalming ty VL L | | 1 if Washing and Dressing | i : om | ma ae et Seeing | ii ' Washing and Dressing y ; ‘Bi Shaving | ; : 4 : | | 4 i | Shaving / , zs nt ae Services si. ee | | u “ ee: LE€ | | se of Chairs Transportation Charges Use.of Chairs ae i| Transportation Charges } Church Charges Officiating Clergyman Sin Church Charges SI Officiating Clergyman / ‘emete ary ; i f; ee i | | | i Eu Cemetery Charges Amount of Bill ph pf F. es Cemetery Charges i] Amount of Bill wihiahietalalail Dali ne : : ’ les Ck aes . : | | | i , 4" Music Goods Ordered by/\ Mt | ' Music | Goods Ordered by | / ij . . | | : ai Flowers Bill Charged to ti Y Flowers Bill Charged to } ie = = aces wenn at gsc sie ee ee a amreus } ik DR ' (| CR. DR. eo CR. 4 ' } , ae —_ dint cence ainsi ET a bh ye hogs iylaa ) td. [rv | JC Bc sv | é Kafe" haz yh et Vo) || IO LO \ yO Qerercdr io. | | of eo ; ~v Me. WOO aii | 7 " —_ s =| Yee 77 GE ——I-¥ : I j lJsi@o 4 si (7 J Crete - 1020 00 ' iE rH | i \ c Bau p i ole | a | 7 as. aro ~ Ht , We — fd [ i eet “| | } j " i || i ' a | | : | at ‘ ea | i i it ‘| | | | | . | | H 1 | | } | j | i| | | : " _| ! | | oii F ; i | i a \" = - si | -| | | | | = II ° Dacian ; M4 ea i ar eae all - | } | | | li | | | | | | | : | ay ~j | | enttiionn - — | sieaiieicidiicl ; a | | os | | | | 7 | | | [| - a ean stn “ | ' | | iI I 'SO8VUEO BY DOUNTEE CASKET co . BOBTON, Mass. tor) 1SSUEO BY DORNTEE CASKET CO. BOSTON, MASS... 1016 re eee Sree een | 98 ‘4 Yearly No. / FOR THE FUNERAL OF Total to date 4 bx. CQ Residence T Place of Death Wife or Widow of Date of Birth 19 | Years Sex Color or Race Month (Day) (Year Date of Death 19 Age Months 4 Single i Month (Day (Year) Maiden Name | Days _ Married Birth-place Occupation Name of Father His Birth-place ‘ Maiden Name of Mother Her Birth-place Cause of Death — Primary Secondary Certifying Physician Residence Place of Burial Cemetery neral Service J Funeral Servi at Lot No. Put in the Diagram one mark like this Winsn of Rarcion Crea No. | for every Grave in it. And marl Burial with double dagger thus : Date of Interment Secti | : ; oe Designate site of monument thus: C] P 4 lied teccalia me a sci ave sca aiid a Casket or Coffin No t Is ap V0 O G, Candles I i Made by Gloves | Lining and Pillow Set No. Bearers or Porters | « | iH} - Handles | Hearse to } A its Plate Removal | Outside Box or Vault Coaches i Burial Suit Slippers Newspaper Notices I} | I | 1 Embalming I Washing and Dressin ; 4 O 0 | 1 Shaving a yp | I : Ms oh | Services { £ | | a go 1 Use of Chairs TU é Uy Transportation Charges Church Charges Officiating Clergyman SEB Cemetery Charges 3| ©O) Amountof Bill Zi Music Goods Ordered by | Flowers Bill Charged to DR. CR. Yob Q d iio } | Las | } i » & at TO Qtek WOOL | Vbleo! HIE | Ge see | y I,Oc ) | | { i — | = cal e ok e os | | = £ oe a es ' _ | a a d 2 Se | t | ij | | | ' 4 be | 1S8UEO BY DORNTEE CASKET CO. BOSTON, MASS. 1016 RECORD AND BILL OF ITEMS . Yearly No. Vy. Mf Yeteeee he Ve | Khon y eer | Noche Residence Place of Deat!i /\ Date of Birth Date of Death cell. Maiden Name Birth-place Name of Father ha, Maiden Name of Mother.. leh. Cause of Death—-P rimary, Certifying Physician, Place of Burial 7 . 7 r pace Funeral Service at 3 pow TF kina: Time of Service ts Date of Interment U Casket or Coffin No. Size Made by Lining and Pillow Set No..... Handles Plate Outside Bgx or Vault Burial Suit Slippers > Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges / Le re. ty anPlanas. = 6 AY t ALLL Ve iio ee FOR THE FUNERAL OF Tota/ to date (hora | } {f ? : ttunk 4 Wife or of Wh Tien Sex Color or Race ta 19 { Age Y Months ¢ Single _£) Days Married Ll” RL, iG 2. = =. Occupation Nt R_Lkid i , ty is Birth-place _, oP CO LL Cg A e ler Birth-place € 8 . s Secondary Residence ie [ Lot No. | Grave No. 1 . gen tA YG [a3 OP: Candles | Gloves Bearers or ne f Hearse to /\ vs af ¢ Removal Meode : Coaches Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Section Designate site of monument thus: i ia utrac', ( re 42 OO Ss & 5 Newspape1 Notices JOP i} | | } Transportation Charges Officiating Clergyman CH S ] ~ Cemetery Charges | | Amount of Bill _ tedec i} | Music I Goods Ordered by ¢ x d VQ ePerrad | Flowers Bill Charged to _ SS ra ST arma ! _— a DR. CR. QA = rar reas Ws ee 7 YO Meech Bree OO) 21 fee, ee ~ | ie 4/1 fi a ‘oe /O\oCo o ae || : — ; i : i | Ss ok ee 1 i Je2o | oe | £ | 4. +? -~ oe love ° | - % AG. | | | Hes} | ’ . | tee me —| | ‘ P , : i | . | bork Fu [Sh | | i , rT; 4 i 4 C ” Te A p, o 1 | = | 4 ROE 4c | a OD OR aR ea, thee _ | nie 7 eos | Lol ee =" — | | og ae —_ i\- i | i - — saidiont | | | x } — oe - 1] - ij —— —_ | I i. cia 7 a ae _ | \ 1SSUBO BY DORNTES CASKET CO. BOSTON, MASB., 18t8 j ; : ne ee a a Se ecm 2 | 100 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Residence Teen ° ne Place of Death QXkreo Bie JY Uw j G3 Yearly No. ' Tota/ to date Wife or Widow of z tf Years Sex Color or Race Abra. - Date of Birth Th (Le, Date of Death Hb, | 1% 920 Age Y Months § Single a Maiden Name ‘ ; Days Married ccc @ rev ~ Derr Leeann / & a Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician 2 Residence Place of Burial Cemetery T Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : Funeral Service at Grave No. ce 47,0 of in, / < ... Section Tin e of Service Date of Interment Designate site of monument thus: { ] ( ‘asket or ¢ ‘offin No ft INBOARD a Candles Size Made by ay Gloves i Lining and Pillow Set No. Bearers or Porters Handles —, | Hearse to Plate | Removal ie Coaches } Op, ts ea wuld Outside Box or Vault eDic Burial Suit Slippers Newspaper Notices Embalming } Washing and Dressing | Shaving ] Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman oo Cemetery Charges Amount of Bill 4 105 = I/O: Music } | Goods Ordered by UL wv = re oe eli {| | . ' pf Flowers I | Bill Charged to /. | DR. U'\ loi A and Bee 1SBUED BY CORNTER CASKET CO. BOSTON, MAES. 1018 RECORD AND BILL OF ITEMS “) Yearly No. FOR THE FUNERAL OF Total to date C4 ga FU Mat T Ba ght Ob. Nau heeras| Residence Kate oly hen Place of Deat): /¥ ttt Date of Birth Pra oe wf f Years Sex Wife or Widow of Color or Race (Moth) / Day (VSer) Bec . Date of Death g ak, lO 197-2 Age ? * Months Single e\ (Month) / (Day) (Year) Maiden Name Days . Married Birth-place Occupation Name of Father 3 “a His Birth-place Ngee Rew Ce ya Maiden Name of MosKer Cc betes ah, fer Birth-place AK ALLL eo et Cause of Death Primary Mtenses 4 Ye fadlan lary ; Certifying Physician by J Distt ctimecuain nce Cel Place of Burial Oveaheet Ch cet Cemetery 7 fien. tl Lot No. Be | Grave No Put in the Diagram one mark like this ; | for every Grave in it. And mark this } Burial with double dagger thus: t / 7/ “er Section | | L Funeral Service at Time of Service Jate “J - } F Date of Interment Designate site of monument thus: Cl) Casket or Coffin No. Candles V] 9 | om 0 NEsD Size Made by Gloves Lining and Pillow Set No. Bearers or Porters Hearse to Handles Plate Removal Outside Box or Vault Coaches | | | Burial Suit Vv Newe H a) loo Embalming Washing and Dressing Shaving Services | | Use of Chairs i| Transportation Charges | Church Charges } Officiating Clergyman ee { | - - Cemetery Charges | Amount of Bill 2p 7 F e¢ 2 Music | | ,o0ds Ordered i 4 ] Ke me Flowers Bill Charged to (Ut4e pry Orrk @ $ Tie dis ihe — SN DR. CR. mr | Veéleo) fyce/'24| [ruky + eee i ak a | | | | 4 | | ISSUED BY DORNTEE CASKET CO BOSTON, MAGS. tote ‘ } ' ( i” Yearly No. n (/ Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment ane ET Casket or Coffin No Size Made bry Dy Lining and Pillow Handles Plate Outside Box or Vault Burial Suit Slippers Embalming W ashing and Dress Shaving “sé rvices Use of Chairs Church Charges Cemetery Charges Music Flowers 7/ 7 Hb, Primary 7 Yee Oh. val FOS. /Q4<vO Set No RECORD AND BILL OF FOR THE FUNERAL OF M OvAKcT atest eo Wife or Widow of c fanart nto L4 Year oo 2p Age Y Months (Year) Days Lecce @ rey KR Qerp Lercanu/ Occupation His Birth-place Her Birth-place Secondary Aesidence Cemetery _ Married ITEMS Tota/ to date Sex : Color or Race Single 44 an, | tbs y Le Lot No. / ea sf Grave No. Section Put in the Diagram one mark like thi | for every Grave in it. And mark thi Burial with double dagger thus : 7 Designate site of monument ibus: [ } Vas Candles () Gloves Bearers or Porters hy + Hearse to Removal 1) Coy Coaches Newspaper Notices ty Shae pacille Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to Ao On CL vw oe de mannii (Sneak. \fe8 ee > ge Sater Sy | = theb y Vewrr|| 7 1 198UED BY CORNTER CASKET fo , BOSTON, MAES rete Yearly No. Kesidence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of MotKer Cause of Death-—-Primary Certifying Physician Place of Burial funeral Service at fime of Service Date of Interment Paz t ae et RECORD AND BILL OF ITEMS FOR THE FUNERAL OF bya WM Noub? be ry ghh— jOl tAAA bhaeee fs LLA We Kate oly yl Jee. Tota/ to date Wife or Widow of Years Sex Color or Race Single CA Days | Married (Meeth) { DI ) y ¥ ) Ap 4 ‘> #™Months ! (Month ) j Occupation . y His Birth-place Maer Aes Ce rea < balepe Ctnw afr ——Her Birth-place <Leee “a-C_- he Heme gts fet haen eeier Aficlersnso. J SC Cec djer dee fesidence Cele. cr Friiety f ao A ei Kh (Cemetery N Lot No Put in the Diagram one mark like this { for every Grave in it. And mark this Burial with double dagger thus: } Section ecuon ‘ Designate site of monument thus ie Grave No a ee Casket or Coffin No. Size Mac Lining and Pillow Set No...... Handles Plate Outside Box or Vault Uurial Suit Slippers itambalming Washing and Dressing Shaving Services l se of Chairs Church Charges Cemetery Charges Music Flowers aii New. Candles de by Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices Pransportation 4 harges ; | yinan ; a | 2 F120 Rok Wy An. Goods Orderes ah } Bill Charged te (eee phe, OAc — _ i a7 —— Ofheiating Clerg Amount of Ball 2 Tae tensa ee DR. \/ duty 6 Qt i i | ee | 198UEO BY OCORNTER CASKET CO BOSTON, MADE... | RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS Yearly No. J FOR THE FUNERAL OF Total to date Yearly No. FOR THE FUNERAL OF Tota/ to date d igen, 474L4, le en Ce Mbeeere hace CA Residence me? hau Cruler of | fesidence CL he om Place of Death of. f £2A~* - Wife or Widow of Place of Deat!: (ith 4 - Neck hrtal Wife or Widow of Date of Birth KY *y f v7) Years Sex ace Color or Race Date of Birth hhavt . 7 cays abo ( Years Sex teen a8 Color or Race S (Year | 7 Month . Date of Death Le ¢ 1vyO - {1 Months 5 Single : Date of Death “ | Months 4 Single Ke LAD eo (Year) Di Is jonth ) Year Maiden Name [,.50 Bren 5 le Days Married Yen : LiL j Maiden Name Bangi oe { Davs | Married ¢(/6~* 7) . Birth-place Oks i asd AnD ©. Occupation Ke & CL St. Atha, Birth-place : ie Occupation Cost Name of Father / ALSks treZQ/ | His Birth- place Cbscocrke ZG n©& Name of Father Thu Aw His Birth-place! / Maiden Name of Mother as & U Ao rene Her Birth-place Maiden Name of Mother... Aa Baw tie Her Birth-place Secondary acre ee eee atta Cause of Death— Primary 4 Secondary Cause of Death—-Primz ary ‘ >} ys é 0 , j Certifying Physiciz “y) AN es O Residence wi, Ceitifying Physician fyettaton Residence Ck, Place of Burial V aaa *Wv comp Cemetery Place of Burial etinn Ob fet Cemetery / Funeral Service at Lot No. Put in the Diagram one mark like this Funeral Service at Lot No. Put in the Diagram one mark like this o e At 2 >. I for every Grave in it And mark th QO z ‘ - y 4 - f : . ° for ery Gre i t. And mark this : Grave No. lime of Service ; ‘ Grave No. J Se artes ; Burial with double dagger thus : t Burial with double dagger thus: $ Date of Int 4ql. “1¢ vo Secti oO ate of Interment \. pechon . . Date pection F | Designate site of monument thus: ate of Interment a < Designate site of monument thus: 7 SU CCA eee noone aa TA ear mc ; = — ice = ill areata sal al slaaiieiieeemanea Casket or Cofhin No t Nl 2 pan EiMed, Rp. heal, Candles Casket or Coffin No. lo 6, @ O. Candles | } size Made ou Why | Nena ; | Gloves | Size Made by. Gloves Lining and Pillow Set Not Piri : 2 | Bearers or Porters Lining and Pillow Set No...... Bearers or Porter be be Handles fo O.)O | Hearse to Handl Hearse t Lf tale, Plate Removal Plate Removal A - ) tbe Outside Box or Vault Coaches | Outside Box or Vault aches ; | bpo / | AGO Burial Suit } YS jurial Suit Creede r-ee ha 3\00 FE aaa St Time of Service rn Slippers Newspaper Notices | Slippers Washing and Dressing Vashing and Dressing | } , | Embalming | i mbalming | | Shaving Shaving Services ervices Use of Chairs Transportation Charges | } Use of Chairs Pransportation Charges Church Charges Officiating Clergyman s i Church Charges Officiating Clergyman Cemetery Charges Amount of Bill “4 Fw at eae i Cemetery Charges Amount of Bill > LO m 7 Jee. CR ok Music Goods Ordered by na Music Goods Ordered be&# Flowers Bill Charged to ia P flowers Bill Charged tq Z Chaenkes Sh sary Besecee a DR. CR. SY 2 a> jammer {SSUES BY CORNTEE CARKET CO. BOSTON. MASS. 1018 ‘ ; . {S8UED BY OCORNTED CASKET CO, BOSTON, Maes. * } ia | t RECORD AND BILL OF ITEMS | RECORD AND BILL OF ITEMS 35 a Yearly No. ~~ FOR THE FUNERAL OF Total to date : Yearly No. FOR THE FUNERAL OF Tota/ to date f) J : ' : / Wn ( UW | bch | / [ha °Gv BA Kae Mert tus C rf WU Ko a Vt ; Residence ye ar Ee Ka wk, Residence Place of Deat! Wife or Widow of Place of Death [Y-@4sar eh Wife or Widow of Date of Birth (Cees ( (0 194 ( ( “ U Years Sex Color or Race Date of Birth iY Years f Sex Fe Rend — ,. oer br Race pa see (Year) J r (Moo YR. (Year —— Date of Death 19 Ww Age (2 Months 9 Single ate of Death oy {8 192 Age 1 Months ) Single pm (Day) 1o-4%} | ; (Month) (Day Yeas 1 | 7< : / ‘ J A AY Beis L Days | Married Coeds Days Married Maiden Name Ce wer GL Occupation ? Maiden Name yp eer Co ee . A estore Birth-place fn $ Rirth-place Onmons 9 ; sees" Birth-place Fas ce upation Name of Father\/ Aatumy Wepte, : haurfon His Birth-place = £. Name of Father a Ad Kaw His Birth-plac evra hie a Oo, wR P_ ho fe <ork & n@ ~ is Maiden Name of Mother [0 <4 ee Iv “f WO Her Birth-place Maiden Name of Mother rf Kevan Her Birth-place Cause of Death Primary’ e Secondary Prensepecnse Cause of Death— Primary Secondary j > ‘ — ee : ei : ae a 7 Cel. Certifying P hy sician Koc bra GAA” Residence Crke Place of Burial ba BS w ox» Ch— Cemetery / Place of Burial “ oe Cemetery / OY Lot No. Grave No. caine cade f £4. “ ot No Funeral Service at ( Qtr ™ Le eh Lot N Put in the Diagram one mark like this ‘uneral Service al ; : Funeral Servic Put in the Diagram one mark like this { for every Grave in it. And mark this f ; : Burial with double dagger thus: t lime of Service L ‘ i ¢ 7 Designate site of monument thus: [ ] \ . seca mama at x - eR sii ieatitiiaiiiinas : pes es 4 prem an einai se A TE: nena Casket or offin No ¢ ry 940 YY Candles Casket or Cofhn No. \ [LBA ( C€ c Candles | : i} Tene jn Made by k ‘ghee Gloves | Size Made by. : ire Avs Gloves | " | for every Grave in it. And mark this yrave No Time of Service Burial with double dagger thus: } Date of Interment Section . ( Gg | 0 ‘ ] Date of Interment ) he “VC Section ; } a Designate site of monument thus: a eee ee i Size Lining and Pillow Set rede, (doit Ney Bearers or Porters ? Lining and Villow SET No.. \ | Bearers or Porters | Handles Qe ‘4 Hearse to | it Ck or ( Khe} (02 - a Hearse to } Plate | / J) OO Removal | Plate eo coy ke Sao’ Y a| Removal Cutside Box or Vault Coaches | cai bhava ee / sede) Coache | | Burial Suit Burial Suit a 7 apps Shippers Newspaper Notices | Slippers Newspaper Notices : Embalming iimbalmin ( ‘mbalming ibalming CHR Ue | _ _ cA en Washing and Dressing | Washing and Dressing onaving { naving re rvic ~ - t » € ie ervices i Use of Chairs Transportation ¢ harges a Church Charge Officiating Clergyman Church Charges Officiating Clergvman } + £— ' a \ | 2 ' ; : | (2 Beo 7 | , 7 . J { i ¢ x ) i [anemone Cemetery Charges Amount of Bill LH ( ) 1 cen nnanereneenret arena Cemetery Charges Amount of Bill + , icbiiieaiionaiihamaaia Music Goods Ordered by . enemies } Music | | Goods Ordered by ~ ; 4 ft_srd 4K | ¢ te | | Bill Charged to te Use of Chairs Transportation Charges y Se Flowers Bill Charged to sete | Flowers a PPE ENR CE I SE saors et 4 — snc A LE TIE a 22 = = = SRSA A RATE I A NEESER OIE RE ieee ss DR. A CR. ; DR. CR. ; —s f r . a Fy : — ; oxtammannneemmmanmmananngipmemmaes eapatt — epee So EE ew : = A = _ a : " — enn i V0 Ore» eo (Oh g2/ t 2 A } 5 VC Tet G00 : | asad. Li £ Jl | a Z JG ler, MM JA f i} oO ‘ on fe ; paver 2 x / } eee \| i _ | J) 20 | | 41006 | if 4 ®\004 | i —i i ! | : = | 4 . { | ; | : Sie | | | co | | Lg | | | | 7 a 1SOUED BY DORNTESR CASKET CO, BOSTON, MAGE. 1OTe {SOURED BY CORNTEE CASKET CO, BOSTON, HARE, 1010 | | 4 | } “i | | | ” : ” : a a | ae | a Jo ee 4 _ ! mmmvcenl | a | ete Bias meen | . "I a \ 3 gd Yearly No. |" iis ip OR THE FUNERAL OF | A n> Xi Mirus NS nail ihe Residence Place of Death Date of Birth Month Date of Death Month Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. CORD AND BILL OF ITEMS Total to date Sea he. Wife or Widow of 9... ( ? 2 Years Sex Color or Race w... “ Months 4 Single Days Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. : os Put in the Diagram one mark like this | for every Grave in it. And mark this Grave No. as Burial with double dagger thus : ¢ Section Designate site of monument thus: . Candles Gloves Bearers or Porters ; situaccan te Hearse toto. Meee To Corerek | Removal | Coaches Newspaper Notices De, yuR, Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by /\ Bill Charged to HO mi ae har 6 | 1SOVUEO BY DORNTEE CASKET CO. BOSTON, MASS. 1018 RECORD AND BILL OF ITEMS Yearly No. sche FOR ie eg FUNERAL OF otal Residence Tota/ to date Rhett d arte Rat fama Date of Birth Years Sex (Month) (Day) Place of Death Wife or Widow of. 7 Ctenate Color or Race Months § Single inf LE _ (Mon (Day) (Yea: ; c 4 Days Married ~ Ucekec Date of Death Maiden Name Birth-place Mey Occupation His Birth-place © yy Her Birth-place Y/ Secondary FO _jiétidence Cemetery Name of Father Maiden Name of Mother Cause of Death Primary Certifying Physician Place of Burial Lot No. | Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ section - e Designate site of monument thus: Cj luneral Service at lime of Service Grave No. Date of Interment Mae ihe a: ; 5 j Candles r Case FI\OO Gloves Bearers o1 Porters Hearse tod Me 7 Keecec > } Removal Casket or Coffin No: Size Lining and Pillow Handles / Plate Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notie®s Embalming Washing and Dressing lita Shaving Services Use of Chairs Trans} ortation Charges Church Charges Cemetery Charges Amount of Bill Music d dred (fek...@ OR newknio Bill Charged to Goods Ordere | i Officiating Clergyman | llowers =H ae 1SSUEO BY CORNTEE CASKET CO. BOSTON, MASS... tote Yearly No. 4 Residence Vibe Place of Death Arere — te, f (Moat) (Day) Birth-place Hekexe Co ~ fe Name of Father Maiden Name of Mother Pay iced Cause of Death Primary Date of Birth Date of Death Maiden Name < Certifying Physician Place of Burial 49 Ceeig Funeral Service at ( Time of Service 4 a9 : a oy se : Date of Interment 7 CX vy/ tro y TOMS CEMA, re AND BILL OF ITEMS OR THE FUNERAL OF Tota/ to date hithe— 19, FO Voor) 19° (Year) VO Age Wife or Widow of Years Sex Color or Race Months 4 Single Days Married Oce upation His Birth-place Qhsy wre tier CB WW CU Her Birth-place. @Q@2RAp Ree fe, Co pO Secondary Residence Rok C emetery { Lot No. Grave No. Section Put in the Diagram one mark like this 1 for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: CJ bee or Coffin TP Pen Foay: Size Made hy Lining and Pillow Set No. | Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services | Use of Chairs Church Charges Cemetery Charges Music Flowers {n22 Candles | Gloves | Bearers or Porters Hearse to } Removal | Coaches | Newspaper Notices I| } | i | Transportation Charges | Officiating Clergyman Lecce Amount of Bill f “VO. Goods Ordered by Ay? A Bill Charged to A af; . Vib il Y $SSUEO BY DORNTER CASKET CO. BOSTON, MaSe.. 1016 RECORD AND BILL OF ITEMS dr AMew hee Wife or Widow of Date of Birth 19 a Years f{ Sex Maks (Month) (Day) (Year) ie Date of Death Pele v sion IP rn Age Months 4 Single ys L Days _ Married eH Ce FLG Occupation oe : @ ss Name of Father "Tee : His Birth-place 7 Atria. A? Maiden Name of Mother QL, oe Salles iter Birth-place Neko @o Tes Cause of Death—-Primary Tota/ to date “fpr Yearly No. FOR THE FUNERAL OF Residence Place of Deat!: Color Zz Race Maiden Name Birth-place ; Secondary c . . F ved | Résidence € Bfawrte e. @ i eee oF St ANcémetery Funeral Service at Lot No. Grave No. a a Te ¢ fs v Section Certifying Physician Place of Burial Put in the Diagram one mark like this We an al Raion | for every Grave in it. And mark this sie my rer: Burial with double dagger thue : ¢ Date of Interment Designate site of monument thus: ee A a Casket or Coffin No. Lew Irae ofA y 15 0 Candles ] Size Made by Ginuee | Lining and Pillow Set No... | | Bearers or Porters Handles } Hearse to | Plate Removal ] Outside Box or Vault | | Coaches | Burial Suit } Iv po | Slippers Newspaper Notices Embalming Washing and Dressing Shaving | i . . | ' Services | a ‘ | | Use of Chairs } l'ransportation Charges \] Church Charges I} | | Officiating Clergyman i} : Cemetery Charges i | Amount of Bill Z f/oojceo i | ee Music... | « Goods Ordered by Oh orn lé ; ALA i | c a Flowers i] ! | Bill Charged to ‘7 ’ Acvely Lilaed 4 Ke? CR. x 2wiIco Jd\oe = ae. le | L@e joo I } ISSUEO BY CORNTEE CASKET CO.. BOSTON, MAGS,. 1000 ;' 111 ate a RE REL Certifying Physician Place of Burial ll © Funeral Service &t CK Cherrabhi or no Residence, es a Ch iestiien’ ——_——, Put in the Diagram one mark like this hy Clu Youu. [hate oes Ce Certifying Physician AY Place of Burial Funeral Service at a ¢ Deed tertletes A Cor eT Cemetery re / Lot No. | 110 4 RECORD AND BILL OF ITEMS : ee RECORD AND BILL OF ITEMS ray 7 FOR THE FUNERAL oF Total to date Yearly No. FOR THE FUNERAL OF Tota/ to date. ee Sf tal tee lou desta 2 Maser Residence Residence Cotte hoa, Place of Death Z a of Place of Deat! Wife or Widow of ace Oo eat ife | c > _ " —_ Mopth) 3” y a / eas a Color or Race Date of Birth wb ’ oo 7 Years Sex os Color or Race Date of Death ts - an a Age Months § Single , Det of Yeast 1082 nae Siaatin ¢ Maite ,? Maiden Name co Mt v - M a. avacrtmneme (Year) = ; : _— ' wey ; ne (pf. lake — Maiden Name - (ajo ( 2 Days Marrickte Ma uerd Birth-place Occupation le. Lrrte ; ‘ “A D ee oh) Mtr Birth-place Occupation te > eee ab Canes aE tiie Bicthplace Name of Father Ui His Birth-place Pr 2fier h. i A ABE Maiden Name of Mother -Her Birth-place - * Maiden Name ef Mother hy Her Birth-place ft J ‘ t Cause of Death— Primary Secondary t ; ; ; Cause of Death Primary Secondary Put in the Diagram one mark like this { for every Grave in it. And mark this Time of Service nH cae. Grave No. I for every Grave in it. And mark chi oe ee if ees * G N D fl fe y } 9 ke, > S Burial with double dagger thus : ¢ Time of Service 4 = J / yrave No. ; Tisiiel Sd Menthe di teas i ate of Interment ed Secti - 2 Snel ection Designate site of monument thus: [ ] Date of Interment ; - ¢ Section | Designate site of monument thus: t ] - ‘ 4 L | ; 7 =a ~ a Casket or Coffin No. T 1903 Candles | Casket or Coffin No. TKLAKO | 1 %ZCE2)| Candles | | me al | | Size Made by Gloves Bin Made by | Gloves ; ng ae ae et sicameasaneas Ont t Lining and Pillow Set No...... | Bearers or Porters. } oomenee | er vi Handles | Hearse to ie | HHeaies ta ———- / cloo Plate Removal Plate | | Removal G4LL. / X, Cs ¥ | wlo Q Outside Box or Vault | Coaches | : I lc dd C TS / 6 O° ‘ soache: Outside Box or Vault A Cogghes, af Burial Suit Y2~ meet | Burial Suit LESS GO\oo | Tio here, fauce * erkte., fv js rte L kere /< | ms | | b: | Slippers Newspaper Notices I Slippers ! | Newspaper Notices Embalming Embalming AI PO | | | | | Washing and Dressing i| | Washing and Dressing | | 1 ] i Shaving Shaving ..... | | | Services | of Services | Use of Chairs Transportation Charges r Use of Chairs __/ a : i Transportation Charges ‘ Baha : G che aut Fi atanmng OOo |i Church Charges Officiating Clergyman BAT Ans, ae: OE | Church Charges Y, ° | Officiating Clergyman sate cea caaal . aes i \| Ff . Cemetery Charges Amount of Bill (ji oO _13S5j00 Cemetery Charges remeron inte | 3 oOo | Amount of Bill wisn hee 2, ; p ; i Music Goods Ordered by Ly, l Music i | Goods Ordered by nO ‘A i] Flowers Bill Charged to Flowers | Bill Charged to DR. CR. DR. CR. “4 - -Z. l ii aati ‘ 2 Kaa. pm | | ~ o ~ Z | | Joaorth tegen, / 3 be MEK fro hk. “Dna | J eyteo Vh2~ anand. 21700, Ste r0 4, Neng | ZF co onto seinen . — ee 7 — | a {- wt Ba . sinensis an | —| - — pa na ~~ a a af oo me: | =. | | 7) 4 | | = | —— F J |——-4- 744 \| } } “1 | ; | 1 orn | Pree a oie | si | ae | _|| | | 1} | | | — - j ie | —_______— 4 —|| —— i } | 1 | | = i] - i : "4 “| e ae i] | ae ] | | | = “| i} —| _~ — i} | r | "| i| _— ! ail | —| | — | | i I v4 | 5 ra i | La : fe } eae a es | | a | il ss 2 e bea i ve sales asl setetndi i i | } | | I as | sae se ie Aisne aaa | | | | i Hh . nscale a : iteinmeesni cine snl sina ae | | a al jaca ; ieee aemnak | od | | ———— lets af intieieannma _ —————_—— Sean — | _ ! i af es Se ees pomnaneci one a | ———_ : _— vcesannanacell eisemnenat sie ania menial | | ha senile J oe “I omer he a con } ints sli dle | | } _ esemaanaRaRNRT HCFA . . e = 188UEO BY CORNTER CASKET CO. BOSTON, MASS. 1016 SY DORNTEE CASKET CO., BOSTON |, MASS.. te18 SF ccacbastumedeunadieeeeesan 112 RECORD AND BILL OF ITEMS Yearly No. Residence pS y Ayn a @ bes ; mer $0 o ‘ian Place of Death Date of Birth Date of Death Maiden Name Thy v Birth-place Bate Name of Father Maiden Name of Mother 7, AUULLLLZ Cause of Death— Pri OeAtn_soh= KWeGsk9-—— Time of Service | { QAAK, / beds SE [ro / Place of Burial Funeral Service at Date of Interment he rt ae ~ “ Size Made by Casket or Coffin No, ¥ Lining and Pillow Set No. Handles Plate Outside Box or Vault / Burial Suit NV C49 Slippers Embalming Washing and Dressing Shaving Services Use of Chairs, it Church Charges J hak Varrk 4 having Cemetery Charges Music Flowers a ee a fot? "Pw Certifying Physician Coats. z _— FOR THE FUNERAL OF aK. f76 (Year) 19 Vv? Age Cerfiete Lot No. Grave No. Section VOdA2.. Transportation Charges Secondary p ——-. Residence Gee Total to date Wife or Widow of Color, or Race kets . Years Sex p { Qo Months “yy Days Single Married Y. Cd Occupation m His Birth-place (Cgficdha. 2A ' Her Birth-place it > 4 Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : + Designate site of monument thus: [ ] Candles Gloves Bearers or Porters Hearse to " gadget. : fale 7 Sr Newspaper Notices Removal Coaches Officiating Clergyman Amount of Bill Goods Ordered pyL rete Kan gh Bill Charged to | es 1SBUEO BY OORNTER CASKET CO. BOSTON, Mase. 1018 Yearly No. Athy Residence Kasia bem a a Place of Deat!: K Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death—Primary Certifying Physician WY WW RhBin—_ Orde, Kercah. TE Place of Burial Funeral Service at ‘ Time of Service Date of Interment | Casket or Coffin TaD Size ; . Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving . Services Use of Chairs Church Charges Cemetery Charges Music.. Flowers —s 7 (Day) 113 RECORD AND BILL OF ITEMS Miirda. "CO THE FUNERAL OF Tota! to date... Af tokawr/' jena alte Sex Hemeate Color or Racé Single : ae oe Married or Widow of. 19 Years 19 So Months Oima- =| ; Days "T\2.- . Occupation ; His Bixth-place Pie haee & Ke Her Birth-place eZ Secondary ‘ Residence Get, Cemetery - . Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this \ Burial with double dagger thus : t Grave No. Section / ee mf/r Oo | Designate site of monument thus: C) Candles Gloves 7) | Bearers or rf s fe | - ; Cee | Hearse to Ayaot . AK || Removal | Coaches | New spaper Notices Transportation Charges | Officiating Clergyman Amount of Bill Goods Ordered by Bill Gparged to we Le pal2e. An fro| a a } ~| {| | | §1S8UED BY DOFNTER CASKET CO. BOSTON, Mm, iN hi 114 { 115 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS “ sh} Yearly No. hk 4 ‘ FOR THE FUNERAL OF Tota/ to date. Yearly No. FOR THE FUNERAL OF Tota! to date 7; -) } : ee ) | “7, j Mh», ves; AH Exe... The) | reek Gaaee “Aew Rar Mela Ya ‘Ip 2p - ; Residence a < . “ly Me a Witty ar |. a. Ae Place of Death y S242 papas ife or Widow of ; i ial, Wife or Widow of : Date of Birth a ss 19... Yo Years sex] Uerale” or” Date of Birth f be, / ¢ — Wi Cay MRL Color ox Race ; (Month) ay) ear) , . 4 : J sie pte Yeah : = Date of Death dey th +o ee _ Months Single me Date of Death Fe - 194.© Age oe Months Single * ° “ i —? ™ _ ‘ (Month) (Day) (Year) a Maiden Name ; y @ zr 5 Jays Married Maiden Name A om (..... Days Married Ce at (Ow > : Birth-place : Ke 7 - : =. Occupation . : ome Birth-place Ve ALRL | A | Occupation Bee ae | | L vy. ¢ Ve Lad fie TK Wis Ditthstdene iat. es et é —= ae Heme af Father V7 ; — aoe ar 2 Name of Father His Birth-place __,2...... © /Ca ‘ V4 K_€ 2.2 ; 0 en | lan se ; Maiden Name of Mother... -——— bs 90 er Birth-place OV. : a Maiden Name of Mother A fo ———s Her Birth-place rahece ~_ ‘<< Cause of Death— Primay ~) a £ Secondary ? nee hia es . £Tisaih —-P ri om Seconda : ae / , Af Cause of Deat rimary..p ( 7 : ry Certifying Physician ‘a ( Tv fi +e Residence (4 Fax ox ec Certifying Physician & (_ ALz. : Bert pesidence Ce. Place of Burial Qs e c 278 4 CO L—Ot_ Cemetery Place of Burial NLefppee Chueh, Cemetery f, Funeral Service at Lot No. Put in the Diagram one mark like th Funeral Service at , Lot No. Put in the Diagram one mark like this ous rao oe ss: , | for every Grave in it. And mark ¢his y : { ; : ; I for every Grave in it. And? ark this Time of Service og Z “7 / a Grave No. Burial with double dagger thus : Time of Service uf or G7 Grave No. , Burial with double dagger thus : f eae ont itaeian wx pe Santi es 7 eo * ¢ Sanat Date of Interment } / Section . Designate site of monument thus: CI Date of Interment J Ts, / Section | Designate site of monument thus: Cc) / es | | ‘ / L | | om pummel eon nn , = 2 aad y re ‘ | . V1 Casket or Coffin No. /L&e, —€ i ae Condes | Casket or Coffin No. v (a4 Ss ee Size Made by Gloves | Sins Made by | || Gloves Lining and Pillow Set No | ere ene | ag Lining and Pillow Set No.... } Bearers or Porters) F | i o i Handles Hearse to | Handles i Hearse to L A for? Plate Removal | Plate } Removal i pc Outside Box or Vault / if Coaches | Outside Box or Vault i| | Coaches | f 4 rto~c4ae “dy, | | ij i i Burial Suit € i Burial Suit leg. 1 ‘ Co | | Slippers Newspaper Notices | Slippers i Newspaper Notices | 1 i} | | Embalming , | embalming i | | | Washing and Dressing | Washing and Dressing | | | 3 | ay e | “>, Shaving | Shaving i| | | Services | + Services | eon : ‘ Use of Chairs | Transportation Charges Use of Chairs | Transportation Charges | Be, S Church Charges Officiating Clergyman [ena Church Charges I Officiating Clergyman —naneenggininae || de Cemetery Charges Amount of Bill i 4 7O000 Cemetery Charges | Amount of Bill ¢ 2 ; Qe K k cutie ana ls ‘ } : ( AOS fr_a__ i Music Goods Ordered by C2 f eee 1 Music I} Goods Ordered by o ; ) Ir - | | ; -—~ t o a. Flowers Bill Charged to e scicel Flowers Bill Charged to ak p__ wae 7 ae CR. DR. oe a f Cr. ~~ | | ; | re . , . of “| A / 7 Likes, i? Ly C loo we ws Za, | Ld des ct F lA Ye feo lc oO A Gas De bk if a : Lf ? oO LL EL A v A aterm 4 {a © | wee ne + - } i r AEE ze ay eee = TT 4 2 ; 7. . | | | a | | =< Gpeylo—ug te a! Soleg } T i oe } ” =i 1} 7 j E er ee | : | sa j ¥ 5 ddl uajledcaeen a a = Lt. } foe > as | 4 —_ j | V we 1] || |, ij , | j | ol in | ¥ | I} _ _ j | | TTT i} i | a ad a | ae a i na | | 1 I -| ~: —— " | = } = | . lad = ————} i | a | ce oe | | | & - - | ee — | | | i | | | | : } “ —- fH = _ | | Hi | j | i | | } = || saad —|| — | Eo | a | ee ee aS | | | | | 2 | in 1 4 1 wail {|__| |] - { -{|———____ oncom —— | | } } a | ome a one ol ee | fii - --—- | T i | | +|— - a | 4 |——_ -|————_———- — ~ soba Dt MNase | Bc atic nhc ea dca dc eis: | él J | | | | | IGOUEO BY CORNIGE CASKET CO. BOSTON. mass. 1010 198UEO BY DORNTEE CASKET CO.. BOSTON, MAsS.. tet] : q cae nm tne eisai Le Ag ORR ott ee ene OnE Sen EST NEON a 114 RECORD AND BILL OF ITEMS Yearly No. Vv s T) K) “Aew fy. 4 Ams Af-@e2ree + Residence Place of Death Date of Birth (Month) (Day) Date of Death { M@nth) (Day) Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Prima Certifying cpemetl ‘ ae J J Kewg Place of Burial Funeral Service at g bbe Sa ) e Corerhk heres Birth-place By~_ heer @ "A_@ FOR t JHE FUNERAL OF Tota! to date. Mrlnewst e7 oy fe or Widow of j Sef Uerele~ 12. oO Years a 1920 Age Months 4 Single ; (Year) 7 * ¢ Occupation His Birth-place Secondary ? +: Residence Haute aes Cemetery Lot No. Put in the Diagram one mark like this | for every Grave in it’ And mark this Time " maeiead 4 e tee Jae Grave No. Burial with double dagger thus : j Date of Interment ) / Section es = Designate site of monument thus: CJ Casket or Coffin No. F Ley CT ; Candles | | Size Made by Gloves Lining and Pillow Set No Bearers or Porters Handles Hearse to Plate Removal | Outside Box or Vault Coaches | Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. Chee 7< ! | | Newspaper Notices © Transportation Charges Officiating Clergyman Amount of Bill a 7 ia ath & Goods Ordered by Bi Charged to Bee t~ > EZ [oe oP? Pt nee, a v seeueo ey CoRntee CASKET CO. BOSTON, mASS. 1018 a . Place of Burial RECORD AND BILL OF ITEMS Yearly No. ASE Tyee Ky Joktar 22 ( J Residence Place of Death Wife or Date of Birth 4 ‘be, f & 19] onth (Day) (Yeat) Date of Death Fee 194. © Age 7 (Month) (Day) (Year) f Maiden Name ) a 2 2 A Ze £> Birth-place ve ARRL VE Occupation His Birth-place Name of Father Maiden Name of Mother... a fi? Qk 44 & Secondary c the. ile cecil tities hLep a3. Ch ni Mt. Cemetery of ae Lot No. Ph, 4] ¢ / Cause of Death—-Primary Certifying Physician Funeral Service at Time of Service Grave No. Date of Interment Section FOR THE FUNERAL OF Her Birth-place ‘ 115 4 Total to date. Widow of : Years (Sex.../ PRLE Color Z Race Months 4 Single ~~ - Days Married Yehere —D ARAL 2k. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial) with double dagger thus: f Designate site of monument thus: Cl pcmmnamnniaiePciammusmiamin: i VJ\0e9 Candles Casket or Coffin No... y Naw Size . Made by.. | | Gloves Lining and Pillow Set No...... || Bearers or al Handles | | Hearse to Ne — / ojo e Plate | | Removal Outside Box or Vault | | Coaches | Burial Suit (leh. { 5 jee | | Slippers | Newspaper Notices Embalming | | | Washing and Dressing | i| “Sx. Shaving | | ‘ Services | | Use of Chairs | | Transportation Charges Church Charges | | Officiating Clergyman r Ei Cemetery Charges Amount of Bill i an f ‘ Faeoc Music... | | 1 Goods Ordered by t Ret — } | pin harged to as Ve cron DR. 19GUEO SY GORNTEE CASKET CO. BOBTON Maas... tete ee rere ee z. a eee . VY Yearly No. RECORD AND BILL OF ITEMS A ; 4 WA a's i. a ae \ en 4 -ho+ A Fak WW.A# AL Bre tc ; Residence Place of Death Date of Birth Date of Death FH, yi 197-0 Age Y Months Single G27 Cele 7 (Month (Daf) (Year) Maiden Name : j /% Days Married ’ , Cia : < ) : Birth-place . ny tly A] . Occupation = st Name of Father J ash o- mon His Birth-place reLeow Cr “A c ‘ Maiden Name of Mother Chk a (/La. wt Her Birth-place te ‘i i Cause of Death— Primary Secondary . ‘Pia Q Certifying Physician br TV I CALs, 1, ea r Place of Burial 6 ceeck, i Yo? Ato ae Ag asad 2 Funeral Service at ~ shi 2.30) nw TCS } 7 20 / baal ‘off OL 0 ef a ' Casket or Coffin No. [4 VY -t> 7 / “s np? te. Size Made by ie Lining and Pillow Set No. Time of Service Date of Interment q Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Ware, of { Month (D (Year) FOR THE FUNERAL OF Total to date NOK ww thin... AQ Wife or Widow of a / Years Sex Ctetdh Le Color or Race Cae Residence. Lot No. : i - Put in the Diagram one mark like t Coane Ma. i for every Grave in it. And mark sh Burial with double dagger thus : Section Designate site of monu nent thus: [ j 1 7 Candles O «4 Gloves | Bearers or Porters | . Hearse to i Sw | Removal Us = | ow Ye oy Coaches : p Stn a’ ‘p a ] j Ol? / Ve Ki @ < | Y / l Newspaper Notices i | | I \ 1 ee Transportation Charges Officiating Clergyman Amount of Bill Fg Goods Ordered by Bill Chargdp jy g z t thes g @. t Ad. he le Im, A- oe NTO O ce ATG | ir ; ow ee Sloo i- 1SEUEO BY DORNTER CASKET CO. BOSTON, MASS. 1018 RECORD AND BILL OF ITEMS Yearly No. a ‘ FOR THE FUNERAL OF Total to date. Hays A ¢ y—~ . Pa Residence yf Lt. Et A gd Wek Ce 4 a) A we : _ Place of Deat!: Date of Birth jonth Date of Death Fe 2. ) Month) / Maiden Name Lil, ver Birth-place Name of Father : ty Maiden Name of Mother Mow the, one. — Her Birth-place Cause of Death—Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment a 2 saa e : 7 | Casket or Coffin No. tls : i Na. —efa |Q0 20 Candles | Size Made by Lining and Pillow Set No.... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges |\-a__e e A Ko 19 Years Sex Color or Race __ (Der) pr ry 19 LO Age Months § Single ( ) (Year) bt Days | Married A Z. Occupation o ap : ‘ S2-pa— ‘o His Birth-place . 22 % - Secondary Residence Cemetery Lot No. Put in the Diagram one mark like this Crea Mi { for every Grave in it. And mark this ' ies , Burial with double dagger thus : t ance Designate site of monument thus: ie 117 OO Wife or Widow of once arin Gloves Bearers or Porters || Hearse to T e Te sone f se sc Removal | Coaches - I Newspaper Notices | | | | | | ‘ S g Transportation Charges | Officiating Clergyman SI4-5|O8 Mawcniii app OAeaglh @yp— Amount of Bill | | | | Music. Goods Ordered by Flowers Bill Charged to . DR. ISGUED BY CORNTER CASKET CO. SO8TON, Maes, 1818 2 118 4 | Yearly No. RECORD AND BILL OF ITEMS dwape) (os Residence Place of Death Cee Date of Birth Date of Death 3 Maiden Name Birth-place Name of Father F Ji @errao Neco Nee Maiden Name of Mother / y ovhe'e Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. 7 Size Primary WIE Qerbe sore Cumuner 126 gy nent nH — WLbA4 |e Bas Made hy Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges VK (Bay) gan 1 e ve WW. Her Birth-place d FOR THE FUNERAL OF Total to date aa & Wife or Widow of bo vain tin. lies Months 4 Single Yed [© Days | Married «heoe @& nea Kh 2 ce h_e =, v 3 19°2? Age Occupation His Birth-place Secondary Residence Ord. Cemetery / Lot No. Put in the Diagram one mark like this I for every Grave in it. And mark this Grave No. : Burial with double dagger thus : Section Designate site of monument thus: [ ] T POLO) Candies | | Gloves Bearers or Porters | : ‘. Hearse to Mt inn / }. Cc | Removal | Coaches | } Newspaper Notices | | Transportation Charges _ Officiating Clergyman Jhos Qebderg | F - Amount of Bill Music Goods Ordered by Whine Bill Charged Qy gi uh Tad, oR Lote bele— 7 V Dr. £ f ~ 3 — _| SO Qtasr (gree | 000 —— 7 | _ ra a oem } cd ow ef se = _ fa ° | | | ‘ ‘ hicicbiol H_ | ice ‘ ‘i | | ds i i ay —|- + — ‘ ae al Peres ae ae ie | I + (S8UEO BY OORNTER CASKET CO. BOSTON, MaSs.. 1918 RECORD AND BILL OF ITEMS Yearly No. Ah, j h A) QO Residence VY Ake Place of Deat!: Date of Birth It. tece. © (Month) Date of Death “VW Maiden Name F; m Y Birth-place Name of Father FOR THE FUNERAL OF 19 (Year) 19°70 Age (pela Cher » Wife 5 & Widow of 4 “2 5 Years Sex Months Days Occupation His Birth-place trehenk & . @ 119 Tota/ to date. af L£ © fi QL tesa £ aa re Married Y ca Maiden Name of Mother** Auer Ceewerk Her Birth-place Cause of Death—-Primary. Secondary ee re ( ie Certifying Physician, Sere O 1 bw Residence Place of Burial C fe Rs ak Cemetery . Funeral Service at CA. , Lot No. Put in the Diagram one mark like this Ti sf Gacwian ‘ Fics Min | for every Grave in it. And mark this ere 3c = Y ? ae Burial with double dagger thus : ¢ Date of Interment “ye LU Section 5 : 7 [ Designate site of monument thus: Cl] Qo ine a ry) & | Casket or Coffin No... v hy GAD haylf O10 VY Candles Size Made by Lining and Pillow Set No.... PO ree Plate Outside Box or Vault Burial Suit Slippers Shei Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Hearse to “V Gloves Bearers or Porters Removal Coaches | Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Cr-S fase em / © r Paes > H 20 Music... Goods Ordered by (~?& Flowers Bill Charged to ta A a a. a DR. CR. : 7 ; ¢ : r a Leek, led Fe of, ft der _ YO Levef—/de2h | /( 1a v poy Ke Hh | 76950 : ee Bic 7 | 7 | is : ee : oo | "7 a et Biel ck oa Wc | nui | a | co ae aaa en | _— nny _ [- om re ee ee ee ES | nei sl sige ee ae nena en I- - ——1 Soe pe = am} censors iain — - - “ | (SUED BY OCORNTEE CASKET CO.. BOSTON, MABS., 1816 120 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Pofece 5 C Aether tea 22 9 a bya ee Wife or Widow of foun (0 Single Married RECORD AND BILL OF ITEMS FOR THE FUNERAL OF 2 Ke Tota/ to date. Yearly No. Tota/ to date Yearly No. er Residence f- 3 ) Cre aterm Place of Death Wife or Widow of Years r or Race i Date of Birth WW ley : ’ (Year) Months 4 Single P Lo Date of Death / 19 xO Age 3 Ge Residence Place of Death Color or Race Date of Birth ee et (Day) (Year) Z 4 d " acca (Day) / fens g ae ate of De: Date of Death Months Days Days Married . : / : Maiden Name wae L-oFhk, i [rechfavr Clay Ge His pirhpeeheee Co Maiden Name Birth-place oe Birth-place Name of Fathe ame O ather Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physicia a Place of Burial Funeral Service at |e Time of Service Date of Interment her { | v0 tp et. Casket or Coffin No. T [dose Size Made hy Lining and Pillow Set No Handles Plate Outside Box or Vault Surial Suit Slippers Embalming 3 Washing and ices Reerey a2 Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. sa Vo eee eee K@tur, pane ap a Ope Her Birth-place et Secondary Kesidenc — Cc cnatonphittied Lot No. Grave No. Section cf. re O00. Candies Gloves Bearers or Put in the Diagram one mark like t! | for every Grave in it. Designate site of monument thus: Por : Hearse to fesse, , Jew Gs, Sennen ae Removal where +r Or Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by leery Bill Charged Og, nr | | I — | And mark ¢/i Burial with double dagger thus : / C ISSUED BY GORNTER CASKET CO. BOSTON, MASS... 1916 Maiden Name of Moth = Cause of Death Primary Certifying Physician / Sir Ga Place of Burial ee FF Csfscas) Funeral Service at Time of Service Date of Interment Casket or Coffin No. < (a+. Size Made by Lining and Pillow Set No..... Handles Plate Outside Box or Vault i 2nole~v Shp Coeff {Men Burial Suit hart = I 3 Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music... Flowers DR. Meky/co Le reecs ret er GFYer Birth- place Secondary & Residence Sone SX ites Ste Pine Birth-place Zlks_x Lot No: Grave No. Section A S1OS\ Candies . / Candles Gloves Bearers or Parters Hearse to Ore Removal Coaches | New spaper Notices Z + 'g, Transportation Charges Officiating Clergyman Amount of Bill | Goods Ordered by Bill Charged to | | | | | } ] | | 1} | } | | } | | ; eo Z Berke Grre Ko tho Fraihaieg Tha RE! Put in the Diagram one mark like this ] for every Grave in it And mark this Burial with double dagger thus : t Designate site of monument thus: Cc) [~ a hy “Boek | i| {| 1] i } 1S8UEO BY DORNTER CASKET CO. BOSTON, MAGS., 1000 122 RECORD AND BILL OF ITEMS — 4 r FOR THE FUNERAL OF ee Residence KAALR2 ov a i. 2 32 i. i, Place of Death Ma@eree ¢ Wife or Widow of - 184 Hu Years aid it Sek Date of Birth ; (Year Date of Death 19 yo Ag 3 Months 4 Single cf £y a of (Year) Maiden Name Days Married Birth-place - ecupation ef Name of Father fpr ote ot Birth-place tie aa 22 “H Maiden Name of Moth Her Birth-place a “nO ih Cause of Death— Primgry Rid "tics Sec ener. Certifying Physician > : Residenc - - \ e al Place of Burial Funeral Service at : : ; . Put inthe Diagram one mark like thi / { "An | | for every Grave in it. And mark ¢/ Time of Service Mt @ f_ (Pp [ 4 O Burial with double dagger thus : f Date of Interment Secti a oe — Designate site of monument thus: CJ Candles Size Made by Gloves Lining and Pillow Set No. Bearers or Pprters. Handles || Hearse to .£ Plate Removal Outside Box or Vault Coaches...“ as | ee) &, (Bases Burial Suit 4 | - Slippers Newspaper Notices an. Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music i Goods Ordered by Flowers Bill Charged to {SOUEO BY CORNTEE CASKET CO, BOSTON. MAGE. 1016 RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF Mbit, Qe At eter $— Total to date. IF 6 Residence Place of Deat!i Nia Wife _— of Date of Birth wy + v7 i9/ ¥ Years Sex Fete Le or Race a Mogeb Da Year) i Date of Death 7 i~ro Age / Months 4 Single Ue ei. sere sie ae 7 Days Married Birth-place ehtui. ylle a C Occupation . Name of Father L \ Alleteu) é His Birth-place ReLoce Ce A eC. ‘J Maiden Name of Mother hey Ka LY. clhececesz Her Birth-place Uo. btu @ne@- Cause of Death—Primary KSevned Secondary . Residence Certifying Physician Ca” Place of Burial Os2ove5 Cocerok ) Cemetery Maiden Name ee Y <n Grave No. aA eh -p/ 0 Section Lot No. Put in the Diagram one mark like this | for every Grave in it And mark this Burial with double dagger thus: f | a Yr Designate site of monument thus: C) Funeral Service at Time of Service Date of Interment i ~~ Y ; Casket 7 phn, Nop. o>, Candles Size Made by... 2F : Gloves Lining and Pillow Set Noma Bearers or Porters Handles Sowa As... A 4 Hearse to Removal Plate Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Washing and Dressing Shaving | Embalming.... i} | | Services Use of Chairs Transportation Charges Church Charges | Officiating Clergyman | Cemetery Charges | Amount of Bill 4 ‘ ‘a Music.. | Goods Ordered by lef € 0€C4 ga tn | (”) | . . } / . | Bill Charged to tha an tO 0 ae Zz & wrens Flowers DR. CR. {SSUES BY CORNTER CASKET CO, POSTON, MASE, 1018 H 1) | | : 124 Yearly No. i Residence Place of Death AN Date of Birth (Month) (Day Date of Death Maiden Name Qe reere Co RECORD AND BILL OF ITEMS dw Wek on yes FOR THE FUNERAL OF Tota/ to date ha 4. ce eo Nay Rest& od. ) Sou Meera le ” Single Married 49 u Wife Widow of 19 5| Years ) a (Year 19 Age Months Days 2 (Year) Color or Race Y - Birth-place Occupation e", Name of Father Tire 4 w colin His Birth-place heLeoe G <a" ' Maiden Name of Mother... [ y) Her Birth- ia e Cause of Death-- Primary, thls VAL (AB Secangh Certifying Physician ; a sidence lettin, — RCo pe Place of Burial QO ean Cemetery / yi ake, il the Me ie Funeral Service at Cee er \ S\( Py rt No. Put in the Diagram one mark like this sin ni Rasta Crave No I for every Grave in it. And mark ¢his { ‘ \ } Burial with double dagger thus : t Date of Interment WMA es b... Oe Section 7 . \ r Designate site of monument thus: CJ saat . zs * * . ee 1 | Casket or Coffin No. Candles | Size Made by Gloves ; | | Lining and Pillow Set No. l| Bearers or Porters - | Handles | | Hearse to | | Plate Removal | Outside Box or Vault Coaches 4 Oy | | Burial Suit Slippers | Newspaper Notices Embalming | mbalming | " \ | Washing and Dressing | | Ig HUG | \ i| Shaving | \ i Services | + Use of Chairs Church Charges Cemetery Charges Transportation Charges - | Officiating Clergyman Amount of Bill Music Goods Ordered by Flowers Bill Charged to aes | OR., > s CR. . MAH od lo Beant. ais. | (( MeOK (0 ees ra i hie 46/60 | | | | F = aoe | | ee | cae " a ae | ‘ — } | | | | f sacs i ee ~— —— | - r wiesitalinaitlinie ~ _ | | | at - | ninheatinimseay } = a nial serbian —_——- } a aw et eo aN sags ) a | = 1 } (SOURED BY OCORNTER CASKET CO. GOBTON, MAG. 1010 RECORD AND BILL OF ITEMS a aK FOR THE FUNERAL OF Tota/ to date.. Mes cee " iar taken, Fa eo” Yearly No. Residence SO Place of Deat!: . Wife Widow of Date of Birth vO { | Years Sex 722 2 Ke Color or Race y) (Year ] 4 Date of Death ~ 19 > o Age . Months 4 Single “fee L406; (Monthy (Dey) (Year) - Days Married Maiden Name oO 4A Name of Father Occupation “© aii os as LI2 _— His Birtl’place <#e ee Ze -x_e@_ Aa Pwr Her Birth-place Bik. S Ae. Secondary Qn ———— Ce Mott Birth-place Maiden Name of Mother Cause of Death— Primary, Certifying Physician } oe a ¢ Warsweone- Residence Place of Burial Qeteeaat Cemetery oo. Poe Funeral Service > a O { Lot No. | Put in the Diagram one mark like this Gosve Mo { for every Grave in it. And mark this oT ia s Burial with double dagger thus: f a. Oh G7 eam a we Time of Service date > p ° . Date of Interment Designate site of monument thus: C) SSS SS SSE Ste Casket or Coffin No. Candles Size Made by Gloves Bearers or Porters Hearse to H-@crce V f Cocmast, | loo Oo | Lining and Pillow Set No... Handles | + Plate \ {| Removal } Outside Box or Vault je” Ke Prydh 1 @ 0 © O} Coaches ¢ OS 2 Burial Suit o us a Mippers Ne “wspaper a "es ff | hu ¢ | 3SC0 | 5100 Embalming Az - : AARL | Washing and Dressing Shaving . Services | Use of Chairs Transportation Charges | Officiating Clergyman Church Charges | Cemetery Charges | L-10 o Amount of Bill / ‘ ee / ] ] @ C/ i { / / Music... | | Goods Ordered by~ A L hore Flowers Bill Charged to DR. 4 ] f f/f f | VOBHUAK V4 he /77\72)\ >< | | j stearate cence tiated Real i | | { | } ! | Se ET a | | - cd 196UEO BY DORNTEE CASKET CO. BOSTON. wage... tere SE Se Se eee | ' Sone RE ETT IIT = ev nenenioeameiatatatt ncaa ntseaneerantes tats eenen tn | a a | 5 2 i a i POR ranean TYEE RECORD AND BILL OF ITEMS hitless. W } a g Residence Place of Death Rs C/ Iv Date of Birth Date of Death Ton 7 Suteere Con Maiden Name Birth-place Name of Father Maiden Name of Mother _ Cause of Death— Primary £ C Certifying Physician AY (p Q- Place of Burial lueteace > Funeral Service at Time of Service Date of Interment Un eh b{2 | re ae a“ Casket or Coffin No.. ¥ / HA ip Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flow ers FOR THE FUNERAL OF Tota/ to date. Wife or Widow of 19 ; Years Sex A ( le (Year) / 197-0) Age “Y Months Single (Year) FI Days Married er Birth-place Be ne Secondary oe Residence” _ fet Ch QR , Cemetery Occupation ./~ His Birth-pla Lot No. Put in the Diagram one mark like this Cue Me | for every Grave in it. And mark this Burial with double dagger thus : { .. Section se : ; oe ee Designate site of monument thus: C) y - 1! 1209. Candles | Gloves Bearers or Porters | Hearse to ... Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to DR | T ease terse | | | “| | | {SUE BY OORNTEE CABKET CO.. BOSTON, MABE. vere RECORD AND BILL OF ITEMS OR/PHE FUNERAL OF Go Yearly No. 4 Total to date - : , / W) thea 5 i IN @_447> £22 2S : f Z, O of Residence / V/S A LaRL # key (Y RLRALA patel Wife or Widow of j : deck #7) 19.79 Years Sex j Re Ca (M (Bay) (Yoar) A Uc r 192% Age (/ Months 9 Single ca (Month ) (Day) (Year) | 4 ( Z C 7 Wyeehepe € wd A C-Covnpation % 224 4414-Y 2 € I # a : His Birth-place hes Ka Lt LEA Ger Birth-place faces Secondary v. (Cock te te ao er. ! Pe Place of Deat!: Date of Birth vs Date of Death Days Married i cog SAS 7 >? tr p< 2 2 BD ~W_< al Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Residence . i ) COneery i . : Lot No, Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Certifying Physician Place of Burial Funeral Service at ap j Grave No. - 7 2 j ‘ Date of Interment WALL q ee ‘ Section | ; ; | bie . Designate site of monument thus: CI Casket or Coffin No. Vv BA 7 Candles Gloves Time of Service Size AS Made by Bearers or Porters Lining and Pillow Set No...... Handles Hearse to Plate Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming. Washing and Dressing Shaving .. Services Use of Chairs Transportation ¢ eharges Officiating Clergyman Church Charges Cemetery Charges | Amount of Bill al : , ie is Goods Ordered by _— tes ALS Lad BNNs ce sticinsres / Flowers Bill Charged to DR | i | ue | { | ISSUES BY GORNTER CASKET CG,, BOSTON, MAED., 1018 ‘” 128 129 RECORD AND BILL OF ITEMS FOR THE 7 OF Chu ohn. Ae . - Residence ae. bee “ar I . “= dow of i RECORD AND BILL OF ITEMS FOR THE — OF Naeree Total to date... 2%. Yearly No. { Tota/ to date Yearly No. Residence Place of Death Wife or Widow of Place of Deat! ate of Bi o ; Wake’ : Date of Birth ae Sar L ean 19 rer Years Sex Cojor or’ Race_> Date of Birth Qe x 1903 Years Sex MaALr Color or Racé ‘ UF. a 2: ( Viks ph) Day) Year) Date of Death ree ee IvVed Age ¥ Months 4 Single qe A | Date of Death AM BR 1 Vd Age 3 Months § Single Y af : i I: 2 ° (Month) Day) (Year) e Maiden Name f Days Married a | Maiden Name t : Days Married ; Birth-place Y. Name of Father Maiden Name of Mother pe Dy Gite P “— QO- P Certifying Physician Occupation Birth-place & le i iii einai ta Riiieelen f a 2 3 deere freee ter Birth-place / they @& “A_2— Name of Father His Birth-place Lek yer Birth-place Secondary Maiden Name of Mother Cause of Death esidencte peniintetienr nnn aE ETT Place of Burial Funeral Service at — Caferotrd ~ Cemetery Lot No. Put in the Diagram one mark like this Funeral Service at i / Lot No. Put in the Diagram one mark like this | for every Grave in it And mark this ; Cause of Death-Primary Secondary a Certifying Physician By CU eX teen Ck Place of Burial a re Pee vemetery Z | } Time of Service Grave No. | for every Grave in it. And mark this ee : = ; D fy ik @ f ~y O Burial with double dagger thus: f Time of Service LM OL ; Grave No. a as oa phage ate of Interment .. Section : : ‘ : - ae x neat is Designate site of monument thus: C] Date of Interment f i Section | Designate site of monument thus: C1 ss ee : ¥ ‘ \ Casket or Coffin No. (& hoe DT hag Candles | Casket or Coffin No. — hare defers Fo Foge QO... Candles } Size —Madb by Glov | an : \ —T | Size Made by || G loves | i : ; : >) Lining and Pillow Set No | Bearers or Pof)s ce | i, + Lining and Pillow Set No... i} | Bearers or Porte rh Handles Hearse to od eee } 4 ee Handles || Hearse to hee eerk_ | PI\OP | - . Plate Li of Removal } HI i| : : | Lp A Plate Removal we | FAL Va f. OA © ho | | | Outside Box or Vault * OLN : 0 Coaches Outside Box or Vault | Coaches } se aces | | Burial Suit Burial Suit | ; ‘ae { { : Slippers Newspaper Ie L, i ‘ } Slippers I a | Newspaper Notices Embalming tag \ } Embalming | 49 0 od | ; : . V cee } Washing and Dressing : bose oo Washing and Dressing Shaving 2 give eo —— aes vw Ir vil c:. Shaving | . . J ’ | } Services yer ager! + Services | Use of Chairs Transportation Charges ae goes i Use of Chairs | Transportation Charges | { } / | ‘ t | Church Charges a Officiating Clergyman ‘ Church Charges | | Officiating Clergyman tia a } Cemetery Charges PP 2) Amountof Bill a iO¢ Cemetery Charges | Amount of Bill | dhealee _Lgaloe ' ; | i Music | Goods Ordered by } ’ Music.. | Goods Ordered by | } | } | Flowers Bill Charged to biel Flowers | | | Bill Charged to | = sii - siiiineamiipial iain DR. DR. CR. . ; - f i. , | Td _ is \) i ke 3| vo aeons Gece | MOKy Lo Cert keer | Bojeo.| ms 6 Fo, Cawt—| se lee | a’ | j ——— | ro -| 4 i—| << | a Por: I | “| | os 4 | _ —} , i } i | | | | a a | | i _ | | | i} i ' | —|— 4 | | | | ! } | | i -| | | i | | be ce | = I Pos + - 4 | | : i | | — ai i\ | | } ' { - | | | | I | ge 3 “| | = | | | | 3 | = | | \ | | sy | } _ - 4 | - i ueneanece j a } ij j | } ener es | i | . os al a set I Ba | re ee i ! ra | {| } } } | | } is - en | : i | — | i’ | “4. | —— aur | 1 - si | a ae | | | | | | | | 1S8UEO FY CORNTEE CASKET CO. BOSTON, MASS. 1910 198UEO BY OORNTER CASKET CO.. BOSTON, MASS. 1018 130 Yearly No. Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father 62 RECORD AND BILL OF ITEMS Oke, {Slater eta. Hb Lan AL beef Kecacd AL a ‘ oY’ (Month) (Day) Weheee Nout ——— Maiden Name of Mother Cause of Death— P - Po UY y . Sele THE FUNERAL OF Wife or Widow of ‘ 54 z / Married . “YAhe Years (Year) Ve Age’ Months 4 Single (Year) ve Days mm Occupation ] OV UAT His Birth-place Her Birth-place Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size LY Cf (fro Woe Geer Tha, Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing Shaving Services and Dressing Use of Chairs Church ( Cemetery Charges charges Grave No. Section oe x OO?. Candles Gloves Bearers or Porférs | Hearse to >< Removal Coaches Newspaper Notices | Officiating Clergyman Amount of Bill Transportation Charges atx Tota/ to date Yauget —p—, wey vias 20d. Cok r % Race “.. t Secondary LY : : a AVY . de Ae Residence , Alte Rew AS d OL — Cemetery Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t a. _— Designate site of monument thus: ie q | e | | | | {| | | fool A ; E ELLGT : Goods Ordered | : 0o0c € € ) Bill Charged to at Music Flowers DR. \ | { | | -| | 3 | “} | 1 _ “\ ee —| ; j 190ah Me pal i , i } | ) Pt (i { | | | | | { | = ic 4 WAVED BY CORNTEE CASKET CO, BOSTON, Mags. ete eo eg RECORD AND BILL OF ITEMS 4 FOR THE FUNERAL OF IQR a HG Poe sa Total to dete. OSL Yearly No. Residence Place of Deat!i ee Wife or Widow of Date of Birth ee / ce ik S 32 Years Wake Color or Race Month) (Da (Yea fe Date of Death Z 0 19%¢% Age -__. Months 4 Single 4 > : (Month) (Day) (Yes ¢ Obetc— our if Z Days Married SLM Maiden Name Occupation resign ce. Av ee . His Birth-place a te bean Her Birth- aa e Birth-place 2 yt heece CO Ye Name of Father E Residence ~v Maiden Name of Mother ..."..? 2 Cause of Death—Primary A 4 een Cerbacesecondary: peste ea feet \f i _— Y~ttWd fal. tt Certifying Physician / Place of Burial Funeral Service at 2 Fr « Wetter Cor Lot No. = Cemetery vin Ae Put in the Diagram one mark like this 1 for every Grave in it. And mark this Time of Service hi rer cr Ah, srave No. thle tL rfre “ Burial with double dagger thus : ¢ Date of Interment Section r (ins eo Designate site of monument thus: CI iia i. Candles Casket or Coffin No. i : Size ; Made by. Gloves I Lining and Pillow Set No..... Bearers or Portess aiid | Handles Hearse to JZ Vk elie @ Meccan | SO Co Plate i | Removal Outside Box or Vault Coaches . ‘ee [dane | 4 JO Burial Suit | A ae Grae PHL re fase leo Slippers H | Newspaper Notices , Embalming ! VA BY VE 9 | Ace I Washing and Dressing | Shaving . | | Services | Use of Chairs | Transportation Charges Church Charges l ; | Officiating Clergyman leit as Cemetery Charges | on p 2 | Amount of Bill _aWilec Music.. } | Cnasda Gudered ins Aft care 5 Flowers | | | pm charged to (Ms / Cee Prenae -| DR. oe ““ ‘ce = MW. | | ] | | | a | | -| By | ISSUED BY DORNTEE CASKET CO, GOBTON, MAGS., 1096 | . | i estes ge gerne spe 132 RECORD AND BILL OF ITEMS Yearly No. OF ‘ ream age Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Cause of Death— Primary Certifying Physician Place of Burial ws THE FUNERAL OF Mother Me /Nukey Her Birth-place Tota/ to date Wife or Widow of pe Years Sex NLL "ote O xd ie ee Oey ae. AC Age Months 4 Single +o Days Aheliiuad Occupation re On fw Married His Birih-plac Cn Funeral Service at “ Time of Service scene actly Meh ss. [ra Secondary Residence a ; Ae ‘Y ery Lot No. Put in the Diagram one mark like this Grave No. | for every Grave in it. And mark this Burial with double dagger thus: t Date of Interment Section oe 2 Designate site of monument thus: CJ 5 } Casket or Coffin No. TG ot ee ul || Candles Size Made “ i| 0 OO | Gloves Lining and Pillow Set No. Bearers or Porters Handles Hearse to .... Plate temoval | " Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming | Washing and Dressing | a Shaving } Services i | Use of Chairs i Transportation Charges | } pate eae Church Charges | | | Officiating Clergyman Be Cemetery Charges i} | Amount of Bill ; _—— Music I | Goods Ordered by , | Flowers | Bill Charged to id. DR CR. 4) iit TSO Qareh beer YROO oe | a = | aE al \- | | staeaeescment {SSUES GY CORNTEE CASKET CO. BOSTON, Maes. tote RECORD AND BILL OF ITEMS FOR THE FUNERAL OF dian Kihess AM Wife or Widow of. Lf O Years Months 4 Single Yearly No. Ch he pict Wate, Nahiles Residence Place of Death Date of Birth 19 onth) (Day) (Year) (Month) (Day) (Year) L * Birth-place Pp ase Coe Cc 3 Name of Father od a (Sy -. “ Maiden Name of —— Ar © Cause of Death Primary Ae leare, a A6KDOLM Date of Death Maiden Name Occupation JA 0 tA His Birth-place J 7h OL <o Her Birth-place (e hopes Secondary Certifying Physiciay Residence Place of Burial Neg) baleen Canciery Wakae + Ken Funeral Service at Lot No. Time of Service /f tee J Grave No. | Date of Interment Section Days Married GH CAd 66 Total to date. Color or Race Bh tts AL cr Bea. baru ge SO Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: Cl) Casket or Coffin No. Candles Size : Made by || Gloves Lining and Pillow Set No...... | Handles ae i \| ~ vve Plate \| \ Removal ™ J — : ; | Y Outside Box or Vault | Coaches ¥ (oy & = Y ttstthe_t.! . a6 | ee zs Burial Suit jf C Sli ; | ‘ 7 Slippers | Newspaper Notices i mbalming Washing and Dressing Shaving .. Services Use of Chairs | Transportation Charges Church Charges Officiating Clergyman Amount of Bill Cemetery Charges i parers ¢ ? 8 , i Bearers or f Le. SI ag py Ce | | Hearse to g Cheese el pe O\}o O ci. i a BI ices | Goods Ordered by Flowers Bill Charged to . DR. CR. we SEG exch KLRe, PE 2 MQ, (Foe iP ana | Ph oo a a | /| : i ee ae | | | | = -— ed | | i| } i eer | | i | i | ae ss ie | ee | Ii {| — ae | |_| oa | i | ae pom i i od f = | | al = | ‘ ‘a Ss |__| we ee : ‘ | | ee * . ; | | | sisci-a-nigeccnale aaa “ll nes ieiscliaseialnaciialiai iia ‘sine aie . ud as 1SOUEO BY DORNTEE CASKET CO, BOSTON, MASS., 1918 134 Yearly No. Lb 7 FOR THE FUNERAL OF / hLhichsr— Residence Aew Place of Death —Wreere. Date of Birth (Month) (Day) Date.of Death Z (Month) (Day) Maiden Name Birth-place oe Co Name of Father Maiden Name of Mother Cause of Death imary Certifying Physic papi Place of Burial Time of Service A fal Date of Interment Leek ie Oo Funeral Service at Casket or Coffin No. Size Maule ech o- Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Ate7j#ttn & Cen ob ei lc 19 F ve pars (Year) 192-2 Age Months (Year) Days ce — °c fac place r Bt -place — hom ery RECORD AND BILL OF ITEMS Tota/ to date Sex Pinks Single Color or Race WaAile Married ren “Ot Page Grave No. . Section Put in the Diagram one mark like (! I for every Grave in it. And mark (/u Burial with double dagger thus : Designate site of monument thus: [ ] asoo Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill 8 Music Goods Ordered by Flowers Bill Charged to me eae | DR. Ee CR. ohm 7 if if v7] Q - [GO| XO Veeerheee | OFo9\ Ua ~ Geto” TT brvvo oe at . | [ — | | See es “a ae a | ected | | } } a ; | | a l - {| _| | | cas | | eae ‘ies i | = : eid Mtl ai atl | | Jd 1SOUEO BY DORNTEE CASKET CO... BOSTON, MASS... 1916 sip espero woes 0 0 sm ce nasi seieg- 9s Meg 7 / RECORD AND BILL OF ITEMS Yearly No. ¢ Pf her Mot Cag \ LOC, vole... Ae Residence Place of Deat! AL G411L Date of Birth Date of Death (Month) (Day) (Moath) (Day) Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment FOR THE FUNERAL OF ife or Widow of. a 70 Years Sex Months L Days Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Single ¥ AL Married Ma Ae Tota/ to date Lf [rome / DD} le Ofte arpa Color, or Race 4 A oe Lot No. | Grave No. ; Section Put in the Diagram one mark like this { for every Grave in it. And mark this Burial with double dagger thus : f Designate site of monument thus: Cc) Casket or Coffin No. Maes Tum Cafe Made by ite V | G Db rctecruth Size Lining and lillow Set No..... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving . Services Use of Chairs Church Charges Cemetery Charges V72a. Se eh MeL Music. Flowers DR. Gud Candles Gloves {| Bearers or Porters | Hearse to Removal | Coaches ZZ O Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to c AAA ieeias ‘ Clu Perri the { al ‘ y. | | | ae Colo Cane Cee (9EUED BY DORNTER CASKET CO., BOSTON, MAGS... e108 136 Yearly No. lr: Lhe Final le ‘ Residence Place of Death RECO AW kisah Vay RD AND BILL OF ITEMS / FOR Di FUNERAL OF Tota/ to date. asses | oe Wife or Widow of Date of Birth eas 4h. a oe a, 4 5 Years Sex Ma Ce Color fr Race Date of Death J hs Me As AC ve Age Months § Single lifct Maiden Name P Lo. Days Marrieg fe rbec Birth-place WAIL Ae Z . £ Occupation 77. AA BA ELC oD. (fLe1._ thers i. Name of Father . atch veer +1. ....His Birth-place Cite} &. Maiden Name of Mother s20.-€ (A LH € ¢ (Bae Mittvalece Sk Mh it 2. Cause of Death— Primary Certifying Physici Place of Burial Funeral Service at ™ Time of Service Af, Date of Interment Casket or Coffin No Size Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Lf 7 _#i2t¢ CA, Secondary Residence Cemetery Lot No. Grave No ] for every Grave in it é ; Section Put in the Diagram one mark hike this And mark ¢/ Burial with double dagger thus: | _ Designate sit of monument thus: { } Made hy - 4 a of cn Candles } Gloves | Bearers or Porters | | Hearse to Removal ( -ogchps ud... Lian fn Ht Newspaper Notic és Nees Transportation Charges Officiating Clergyman Amount of Bill > Pam of YS $U L tka Goods Ordered by = Flowers Bill Charged to CA ta XR gee DR. ah Un we fa £ A f | Ne ce ial WAKA | -| | va | hy | -| Ye | $eUEO BY CORNTEE CASKET CO, BOSTON, MASS. sets oem ereomanee e———_———— 137 RECORD AND BILL. OF ITEMS FOR THE FUNERAL OF ; Cas) u— eee a ear) (Day) 1970 Age Date of Death 2h ( ars (Year) (Day Maiden Name ate Sd eat Cv Occupation Birth-place tJ tthe 6 It ura Cg His Birth-place 76 Yearly No. Tota/ to date pad Residence ot Wie ‘ Tm, Canr-— S*] Years Sex Rane Color e f Months 4 Single Married Place of Deat! Date of Birth een *. Days Name of Father Maiden Name of Mother .~ Her Birth-place Cause of Death— Primary Secondary “ ; Certifying a ‘Dy. “ + = a Residence ela 42 Jf ee ‘ © wil Place of Burial Chinrrob— Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this | for every Grave in it And mark this q . Grave No. Section “5332 Yorn 23, Time of Service Burial with double dagger thus : t Designate site of monument thus: —_ Date of Interment Casket or Coffin No. FS 0 || Candles Size Made by | Gloves | Lining and Pillow Set No..... | || Bearers or eee Handles ] } Hearse to .& hh aut th Cu Xr a\ Ce Plate Removal Outside Box or Vault | || Coaches Burial Suit {tote [02 \vs | Slippers | | Newspaper Notices Embalming | | Washing and Dressing 1 } | Shaving } Use of Chairs | || ‘Transportation Charges Church Charges | | Officiating Clergyman ee Comevery Charges } Amount of Bill LOSj 27% Music... | Goods Ordered by Me ( “yas Flowers | | Bill Charged to Lt i shan | DR. CR. Telnt ol Ral \r os eppregd y Coad — ee : | eae is Z. S | | Jo\Oo I Cadel y Cheek” | Soo | | 2 | T° | 4 a | 7 a } | | | 7 4 | | i cal : a | | | . or a a | ae an | a | al | | | | | + Pt - ; ‘wae - -—4|—--- —| bd oe — i gla si T ane = ———| all ion sslssiainall cell snusininiiansssiiit aa 199UEO BY CORNTER CASKET CO., BOSTON, maAss.. 10t@ 138 RECORD AND BILL OF ITEMS ; ! : i : . Yearly No. " / ; FOR THE FUNERAL OF Total to date. s a ’ e ; A. Linki, Lobo ~-—" Residence Sees? fu Lu tel é / , ‘ Place of Death rw Katt Wife or Widow of _<— ahah Jk Zc? Date of Birth Ma € ‘ (3d yy la 7 7s Years Sex LLL cr Golor gr Race sMonth) (Dey) (Year) } Date of Death a C26: 1Ge& Age “yf Months 4 Single iY ze oo ° s (Month ) (Day) (Year) r , Maiden Name “f Days Married Birth-place Utes Le &¢ ; Occupation A777 tse) os . ’ / ; ; Name of Father fh ct a1 (Kh a te His Birth-place UAerte at, Ce i ~~ Jf \g_4 ? f. Meiden Name of Mother... //-2-€¢ D AN-tC- Her Birth-place VY Acct LC a ee Cause of Death— Primary Secondary a iy J : Certifying Physician K. auc Ze A fn Residence ; o HA Place of Burial box. § ek Cemetery Snel Gocukae's if / J Funeral Service at y é / Lot No. Put in the Diagram one mark like this i al its Lf 3 ae en | for every Grave in it. And mark this = en / lor ¥ Grave No Burial with double dagger thus : t Date of Interment /y if o£ Section Designate site of monument thus: 7 / te = it , 3 ¥ ay Casket or Coffin No. L 4 or . Candles | Size Made by Gloves | Lining and Pillow Set No. Bearers or Porters | ry Handles Hearse to 2s Cen LOCO o Plate Removal Qos i eae? y ( se | Outside Box or Vault Coaches she . — “S 5 2 oe ij Oo Burial Suit a 0 es Gases Marrero S Slippers Newspaper Notices = Embalming Y A.A y LA 1 bau } - 5 Washing and Dressing Shaving Services > Use of Chairs Transportation Charges Church Charges Officiating Clergyman CSR Hn Rene OE (ALN Ree Cemetery Charges Amount of Bill & JOU Music Goods Ordered by ‘ ; Ate" 4 j £ ~ | | Flowers Bill Charged to hacer She 8F ch j DR. 4 sf } ( / 1 Hh / a —|2e aed | j AS lf Be Bawthe LoS ( 4 GEN Q | Of 7s | rid Gg | = |—— " | | | | | 4 a | ' - | | cs i 2 ‘ roe | sista “J } {| ee ) ei me eee l | | ; ! | l 188UEO GY OCORNTER CASKET CO BOSTON. Mase. 1018 wn sense. me senenenteensipitnna aan edict 2 Yearly No. FOR THE FUNERAL OF An Mhoved Nar Residence. | cnt tid / Ee. Place of Deat!: Date of Birth Date of Death Pissed 240 ea Wife or * Witteu of Lv..@. Keb shar 0 19 £90 Wo A Years { Sex Month) i ye 1922 “ I/ , (Mpath) (Day) (Year) - kao — zy .. Days Ccte- po Ce —.~@- Occupation / Color or Race Months 4 Single Married Y ay Maiden Name Birth-place His Birth-place Ve £0 22 @ A . net- wae ow Her Birth-plac 7 he, Ae Secondary Haey MwWate J is < Residence eo hepa a 5 Lot No. | — No. hee Mes & ction Name of Father Maiden Name of Mother Cause of Death—Primary. Certifying Physicia Place of Burial Funeral Service at Put in the Diagram one mark like this | for every Grave in it. And mark this Time of Service Burial with double dagger thus : ¢ Date of Interment oe a ge Designate site of monument thus: Cc) r -ommmanesd em Casket or Coffin No. Candles Gloves || Bearers or Porty VO ke BAAt7 OD Hearse to Size Made by Lining and Pillow Set No..... Handles 1} 1} Plate i Removal\— BS, Ml conceit x ann || | y Outside Box or Vault \| Coaches Spy Le i| 7 iltis v Lae “Ww /« ch. (9 ok? Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving - . | Services | | Use of Chairs Transportation Charges Church Charges Officiating Clergyman Amount of Bill Goods Ordered by Music | Cemetery Charges i ; | | Flowers Bill Charged to DR CR Toh] 27 La) Vee AE, | aa | | ae: aes a | | * 7 “H} —— poeneestetanenment | a a eae 5: a 4 | 74 . | A | a | | oe ie i silos a | | | | 4 | | - ore 4 a | | / | _ sian a 4 | i | | | | |_| | | saaceei eiiaii —|| | i ; | | i ——— ears —aeni ne —— || | Be ees teil + —— ean | 1 a | ea | | I \} an: biibeisici ‘ ad — caliente lk sini | aia —— nsamanmnmannenes eee pneu —4|—— seninnlh cians ain | 140 > 141 4 RECORD AND BILL OF ITEMS RECORD AND BILL OF !TEMS 7 Rial ihe 7 Total to date. 7 Y “U. ) FOR THE FUNERAL OF Total to date Yearly No. FOR THE FUNERAL OF ea Residence Residence Wife or Widow of Place of Death oe es a eae of ae i ae ' Date of Bieth e MBE , f (Day) 559 Years Color of Race 4 Date of Birth ie ig/ q [ Years Sex a 2LeQ Cglor or Race i swe 40 = kato Yeor b tin i Date of Death ? 19 Age — Months Single - Date of Death 3 Age | ¢ Months Single Yad , ( MOL (Day) (Year) on ¥ i = ee - ‘ (Month = } : / ao Married G/@¥ a ; : ac / Maiden Name Maiden Name ¢ Birth-place 0 : i irth-place ecupation Birth-place he” Occupation er i aninadeene Bicglece eS > a: Name of Father fe His Birth-place aide i F eo N ) Cc en een ae eae ha wrnarcre Birth-place Maiden Name of Mother Her Birth-place Mow ar. @ Kee i i Cause of Death— Primar Sec : E a : oe — Cause of Death a Ss: Secondary ~ : yo Residence Certifying Physician C4 << ] Residence v Le ee Certifying Physician Lot No. | Put in the Diagram one mark like this Days Married Cerhetery : ~ ” : Place of Burial Cemetery Place of Burial C-of- at No. Put in the Diagram one mark like ¢/ Funeral Service at | for every Grave in it. And mark this Funeral Service at et Time of Service ved j Grave No. | for every Grave in it. And mark ¢ vo ie C ; ee a ; Time of Service ee tae Burial with double dagger thus : f Burial with double dagger thus Date of Interment LAL ef. Section : : 2 Secti Designate site of monument thus: CJ Date of Interment ieiccacta — ‘iti Designate site of monument thus: a | Pe ne eee = & = a Ste ae ! = Casket or Coffin No. J faa } / r 500 | Candles ] Casket or Coffin No. Dhak. Kawnt L fei. fd 1G SO Candles Size Made by } || Gloves Size Made by Gloves | | | ~ Lining and Villow Set No... | || Bearers or Porters | Lining and Pillow Set Ne B P 6 wre ? earers or Poy | | Hearse toV. ALL he Set Set i Y I lQ.ao22 endles | Hearse to | | Handles Removal Plate | Removal ne telpaleey Plate i | i oe ee | Outside Box or Vault | Coache 7 O( Outside Box or Vault | Coaches | | | | wate stunts Burial Suit Burial Suit Lark teieey | } Slippers Newspaper Notices | Slippers Newspaper Notices Embalming -& | | embalming | Washing and Dressing v toa | Washing and Dressing | | Shaving R Shaving .. | Services LRuUsan oa Services | | ~ | Use of Chairs | Transportation Charges Use of Chairs ¥ | Transportation Charges | Church Charges : | Officiating Clergyman Church Charges \| Officiating Clergyman . | eis Cemetery Charges Jie O | Amountof Bill ss zee. Cemetery Charges Amount of Bill ca Music Goods Ordered by es : wa Music... | | Goods Ordered by Fp aperesnoay Flowers Bill Charged to Flowers | Bill Charged to A 7 DO eee : DR. CR. DR. - ‘ e om CR. | p12, eT ipown vo : Jéaeugeesre | /ov 0 | Ur */ yo - C@eng | /é\vo 7 ; t Rap LL gy | f I 1 } ; d _ | _ . i? } ~ | pl | ba as ae. | m a 1 ' | i i | } | j j | | das = | | | |__| | | | | 1 | | -| 4 | | | | Jaan Ge: Gee Seer ; Z ! 2 | | | 4 4 | Fi | bisa ed {| ; 4 ‘ : | | | od _ “i 1 . “J - i | —} - | | + iets | ort iii satin | | acannon a 188UEO BY OORNTER CASKET CO. BOSTON, Meee. tere sears -atnattateeramannwonsne Nin tee isin ‘ ES Laren 14 3 _ Yeariy No. 7 5 a Residence Place of Death Date of Birth MK Date of Death Maiden Name Mk, Birth-place Name of Father Maiden Name of Mother het G eA Re_ Cause of Death— P “a 7 Certifying Physic ed Place of Burial Funeral Service at Time of Service seston b Fass. Ox {Lo ] ee \O& ae Date of Interment — —; ey he RECORD AND BILL OF ITEMS FOR ve FUNERAL OF Widow of Oo ong (n Se: Tota/ to date. 4 Color or Race a (Year as Age Months 4 Single bhai , (Day) (Tear) | Mivied Yau G@ra~ j “7) Cs = Ae ‘Silenney e Lot No. Grave No. Sis ae leva, — Occupation His Birth-place Her Birth-place ondary Hey be Deer hati Put in the Diagram one mark like t):is 1 for every Grave in it. And mark this Burial with double dagger thus : 7 Section Designate site of monument thus: [ ] Casket or Coffin not . TH OOo Cac tion | Pe Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Blaihe. Washing and Dressing Shaving Services Gy aa - Liog a | | Gloves | | | Bearers or Porters | " Hearse to Na fie I 5, OOo Removal // | Coaches = 7 /0 Newspaper Notices } | sr oe 9 Use of Chairs Transportation Charges Church Charges Officiating Clergyman oe Cemetery Charges Ainount of Bill of vie y Music Goods Ordered by y | Flowers Bill Charged to | DR. CR. } + | 7. . 6 | SL [A AML } | + ; ” ~_ | mn 75 : Wo 4 | | =~ | ; = ; | | ig ee | 4 | | i} ae sin | emcees - i} a Jj v cers . oe eis | | ‘i - | ‘icieliai id | é | |_ af ee | omamene } i 7 i _ . Lice ad, Bs | | | | | | | 1SSUEO BY DORNTEE CASKET CO. BOSTON, MASS. 1010 Yearly No. e Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother. Cause of Death—-Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment (Month) (Month) 143 RECORD AND BILL OF ITEMS 1b FOR THE FUNERAL OF Meust F hacen fbi hts Bic Tota/ to date. Wife or Widow of. le 19 Years Sex Color or Race (Day) (Year) 19 Age Months ¢ Single (Day) (Year) | Days Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. | Put in the Diagram one mark like this Crave N | for every Grave in it. And mark this en eee Burial with double dagger thus : ¢ Section Designate site of monument thus: C) Casket or Coffin No. Size Mac Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music... Flowers DR. de by | ; | . Candles | Gloves | | Bearers or oe ia ioe bro peprtichiees: Se Ee Coaches - Whewlg Err One oY ISB if Transportation Charges Officiating Clergyman i| Bill Charged to So8 a {J Amount of Bill Goods Ordered by i | a PTE TE Oe NET NET ene ane ven enn et pete Se ee Gener re Tete See 144 RECORD AND BILL OF ITEMS Yearly No. q " Drs Residence “ We Place of Death FOR THE FUNERAL OF Qr1er War. or Widow of Total to date. ' Date of Birth aos on 19... . Years Sex Color6r Race Date of Death 19 Age Months 4 Single e (Month) (Day) (Year) " Oko, Maiden Name Days Married Birth-place Occupation Name of Father His Birth-place ’ Maiden Name of Mother Her Birth-place Cause of Death Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this Time of Service Give No | for every Grave in it. And mark this : Burial with double dagger thus : ? j Date of Interment Secti i — Designate site of monument thus: [ } | oe 2 j re ee T 7 Casket or Coffin No. Candles i| Size Made by || Gloves Lining and Pillow Set No. Bearers or Ah g by w Handles ' Hearse to HWyikty Plate Removal tule, re Outside Box or Vault Coaches heidi O 7 : cO Burial Suit Slippers Newspaper Notices q pak Embalming (0. tale Washing and Dressing “eo . (- ell eR O © Shaving : Ane Services a pearl oe si ¢ Use of Chairs Transportation Charges Church Charges U4 | a Officiating Clergyman es . fA / | Cemetery Charges / VaAMKL joe . ? Amount of Bill iar ie Music / | Goods Ordered wv Makras | Mi Flowers Bill Charged to sh ane a . | | ‘iil | ; || | \ WSRVUED BY CORNTEE CASKET CO, BOSTON. Mass. 1948 aes nm a mas . RECORD AND BI Yearly No. Residence (a) Place of Death IO Date of Birth (Moath) Date of Death (Month) Maiden Name Birth-place Name of Father Maiden Name of Moser .. Cause of Death Certifying Physician Place of Br ial Funeral Service at Time of Service Date of Interment Casket or Coffin wd NAG Size........ Made by Lining and Pillow Set No...... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming..... Washing and Dressing Shaving .. Services z Use of Chairs Church Charges Cemetery Chargey~ Music...... Flowers . FOR THE FU Lb - ° Wife or Widow of 19 ay) (Year) 19 Age (Day) (Year) Years Sex Months 4 Single Days Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. Section Grave No. , | Bill Charged lo OF ITE on smoaah Candles Gloves Bearers or Porters | Hearse to Removal Coaches | Newspaper Notices a a py Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered Tota/ to date... » Color or Race Put in the Diagranf’one mark like this | for every Grave in it. And mark this Burial with double dagger thus : } Designate site of monument thus: C) 7 a J) | J et (S@UED BY DOANTEE GABF hie 5 i aes a Re LEN NESE 7 AERRD SLITS aig hate nese ene eR an nen nT ee ait alae eae if a i id ine ees 146 RECORD AND BILL OF ITEMS early No. q — ‘Ting @ © ’ 6 FOR THE FUNERAL OF / ¥ Luke Tota/ to date Residence Place of Death ! . ’” Wife or Widow of Date of Birth ia Pa 19 ( ‘© Years sex PALL F Color or Race Date of Death MOR af SY O Age Months 4 Single Le H 4£¢ t Maiden Name . =o | Te Days Married Yea Birth-place Occupation . : Name of Father His Birth-place 3 Maiden Name of Mother Ae all Seti: Her Birth-plare Cause of Death— Primary pagece: UO com ary a mo Certifying Physician Lf) AN (@ htt Residence N_»2ke- A€ Place of Burial AJ vg UL #9 Orr C Charr~ Charmdty ; / Funeral Service at Oe uv Lot No. . Put in the Diagram one mark like thi Time of Service | Grave No Too a elena Date of Interment 4 A) C) Section icasiisih shia etaniiitiliin tine: CJ ee Casket or Coffin No. Candles | | | Gloves Size Made by Lining and Pillow Set No. : | Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Hearse to 1 | Removal Coaches Newspaper Notices || Bearers or ters / a | AprirssOun Aunt | S00 - Use of Chairs Transportation Charges } } Church Charges | Officiating Clergyman Na rie Cemetery Charges i Amount of Bill a a laa ial Music | Gobds Ordered by * Flowers Bill Charged to ae | DR. CR. 5 ee New _| i) See | s%\e° Se || 4 _ ea i } j } } = j - | - | — — emf | | oe Pd | | | i | _— motel { | \\ | ™ | i | | i Pies me Ss | ee oe | | a | | _ | ‘ | oo | = | | a 7 | ¢ po ie Sihoem ; a ae | oa cia I _ | ow dl | sia ‘ —_—— | i | i ities ——_—__—_— ees 7) - idl nei : = ae | Co WHVESD BY DORNTEE CASKET CO, BOSTON. MAGE. 101e RECORD AND BILL OF ITEMS _ FOR T FUNERAL OCF Z a of YE 3 70 vem (Year) x. 19t0) Age Months (Day) (Year) / ? e : a ecupation His Birth-place Total to date. §o Yearly No. Residence Place of Deat!: Sex Wale Color.or Race Single Married Yer : tttty an Oe, ee Go, AC Date of Birth Date of Death Maiden Name Days Birth-place Name of Father Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician re idence Va } Place of Burial Ctuaradg — metery t i Funeral Service at 3B Shree at No. Put in the Diagram one mark like this Time of Service Z rT / Case No. j | for ont Grave in it. And mark this 2 7 og , Burial with double dagger thus : f Date of Interment ‘ Z +t Section Os | r Designate site of monument thus: C) Lo eo = sie ehaeeaiiiaeaibacan ‘ i tt Casket or Coffin No Cucfe CAL Bye /O0e OC Candles Size Made by | Fe Lining and Pillow Set No.... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music... ¥ Goods Ordered by Flowers ’ (oa | Bill Charged to DR CR. omnia ‘i <Z. fo mt po ry J 0 Ben bree, | 1 vo Jr Hoy a Cee | NV? | ispecies anesthetist aerate rT 148 RECORD AND BILL OF ITEMS On THE FUNERAL OF Tota/ to date. A-ercatoy o Wife or Widow of 463 Years Sex Color or Race (Day) (Year) i 19 Fo Age Months 4 Single (Year) Lehto His Bisth-place Yearly No. s { Residence Place of Death Date of Birth Date of Death Days Married loose SC 6 @ Her Birth-place AALO4 11 _4_SEcondary a ; Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician Residence Place of Burial ] etery r eral Service é - - Funeral Service at Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark th Grave No. . : Burial with double dagger thus : / Time of Service SQ v. FOO Od. Candles \ Date of Interment Section Designate site of monument thus: [ } Size Gloves | we Lining and Pillow Set No | Bearers h | } 7 Handles Hearse Plate Removal \ Outside Box or Vault [0000 Coaches | Oe | — ; " rice | ee ee ts ) Shippers / ’ a7 Newspaper Notices I Embalning 2.510 oO | } Washing and Dressing i Shaving | Services i + Use of Chairs | Transportation Charges | Church Charges Officiating Clergyman ea Seo Cemetery Charges Amount of Bill : oy, ve Music i Goods Ordered by t Flowers Bill Charged to OR. , CR. 2 oeate j Ag We Qeuklere | fore An Jeo Ml, Che ol | Yor : {| | sinensis | ——- oe - —_ | aed commend eames ; i | ial | | | a i ————- - - — —— | 1SOUEO BY CORNTER CASKET CO, BOSTON, MASE. tere RECORD AND BILL OF FOR THE FUNERAL OF Oasis. Ty renne Oak Yearly No. Residence Place of Death of Date of Birth Loo’ he Of, Va Oa, (Day) Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother (QA Mtg, Cause of Death—Primary Certifying Physician MN ue Ou bert — Ba test Le. I OAL + Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin ! Size Made wy Lining and Pillow Set No.. Handles Plate Outside Box or Vault * } Burial Suit (Lp fs 7. Ms22 4 Slippers Embalming Washing and Dressing | Shaving Services 1 I Use of Chairs Bet Gece Wife or Widow of L Fy O Years Sf Married / y Days Occupation His Birth-place Her Birth-place te Sec — ITEMS sex esene te” : 19 yo Age a . Months 4 Single Yer 149 ff Total to dete. 20. yf x Btruparte. & a ; ,. J +H at No. | Graves No. ‘ Section HO\O.O Candles Gloves Bearers or Porte Hearse to Removal || Coaches Cars Newspaper Notices | | | | | l'ransportation Charges a AO” vel ts, Pt ch Pooh> ©, Ted Agra / Lojoo Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: Cc) Church Charges | | Officiating Clergyman a i| Cemetery Charges | | Amount of Bill - , . id | | Music I Goods Ordered by Srath RRL : ce — = Flowers Bill Charged to DR. o CR. | D N © E 7 Hil 70 ¢ nn i / 145. pl, Chk 1b, of / (1 hame ooeo 4 Add ol i} et ie e a z a7 | —=——le 4, | JAA ; | } | } | + , 2O0C0 : e mi 150 i | (3 RECORD AND BILL OF ITEMS ie Yearly No. FOR _ FUNERAL OF Total to date | Gh wke Oneal i Residence CB tra VEZ | Place of Death hacegp d Beaton. Crk Wife or Widow of en nee nT nen ene ee ena ee ae oo 4 ia Date of Birth ; 19 | “Xd. Years Sex Nake Color or Race | a ywe""™% (Dey) (Yea : Date of Death / I Age Months 4 Single totitn y (Menth) (Day) (Year) ' Maiden Name Days Married G4 Birth-place La ee Co - VW€ Occupati oa pation . ee Name of Father Cts k* oO! uscal His Birth-place Lae ce (&% Th. @ $ Maiden Name of Mother (Atel y ace Cause of Death— Primary 6: v ok, v ec ity ary Certifying Physician i) Vv . Se ~ Cre ek Place of Buria! Ww | cok wefod bg orto nO Funeral Service at \ a rae ado ee: Put in the Diagram one mark like this | ee \-yo aang Burial with double dagger thu ~ r Designate site of monument thus : ee eA er jet ‘ Conta No... « bale % } Gunde | Size Made by \\ || Gloves | Lining and Pillow Set No. Binsreck A gy Ca, & Fis j Handles | Hearse to it bed ( 2) \c c : Plate |) Removal k te | Outside Box or Vault ‘ ‘ ei C Chr | 7+ B® ) : Burial Suit \ (2 eh Lack i Slippers Newspaper Notices | Embalming en rene Washing and Dressing | Shaving i Services 1 7 ‘ Use of Chairs | Transportation Charges | ' Church Charges Officiating Clergyman eee ena i ' pia Qo? Cemetery Charges | Amount of Bill acs 12 ; / Music Goods Ordered by | | : | } ; Flowers Bill Charged to ee ‘ \ i a ip come] ra alg TT, Bis anes ! | } | | i nol —_—_-——— “ { te ’ = i | | j | | | i ; i | } } | | i } | pepe ts =———- {84VEO BY OCORNTER CAEKET CO... BOSTON. mace. 1016 RECORD AND BILL OF ITEMS Total to date... , g¥ Yearly No. FOR THE FUNERAL OF Sha alg SWharaek Residence ’ Place of Deat!: see ok. Ae. Wife os Widow of Date of Birth 19 Years Sex —= Color or Race (Menth) (Day) (Year Date of Death 19 Age Months 4+Single (Month) (Dey) (Year) Maiden Name y | Married fe Birth-place ll lle Ne Occupation ae Name of Father ot de. Met. tis Birth-place Frans. @e “Ae +t Maiden Name of Mother. ALLL ler Birth-place ce Cause of Death —a Secondary ‘ Certifying Physician ,5: Residence a ; ; Place of Burial bekheer tock Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this uses: No | for every Grave in it. And mark this Time of Service Burial with double dagger thus ; t ite ca_ Date of Interment Hh ee / q ~d Section | : : | Designate site of monument thus: Cc) LQ aa a Casket or Coffin No. A840 > 4.) Candles : | Size Made by Gloves | Lining and Pillow Set No..... Bearers or Porters | Handles . Hearse to | Plate Removal | Outside Box or Vault (| Coaches | Burial Suit | Slippers ! | Newspaper Notices | Embalming | | | Washing and Dressing | | Shaving i | Services ] i | Use of Chairs | Transportation Charges Church Charges i Officiating Clergyman bs Cemetery Charges | Amount of Bill | eee Music.. } Goods Ordered by | Flowers | Bill Changed to | DR. CR. wb Qeect Ctew (re) tIER One Jf / 27 . Bee 1 cal a or em ir Pall WIO | oo ct y wv 19H 21 =| “~ -_ | o ¥ ~ - =e hieare (= HS | | | | = | | 151 nm: ERENT Root tacanaret RO tS SOE EES oT A RTT SEE L/S SES ET I oa IS 3 TS SAE 152 198UEO BY DORNTER CASKET CO. BOSTON, MABE. 1818 San ase eececnsncnninirseananscet ccs ceeiene ae eee ee ~ te 153 | ot ek RECORD AND BILL OF ITEMS £6 / ? FOR THE FUNERAL OF otal to date Hit shai. | Yearly No. Cf. FOR THE FUNERAL OF Tota/ to date 2 N f : 4 ‘4 Residence lifratin Ke* a i ae Laas ; ; tesidence.. ay Place of Death Wife or Widow of Jaa. 4 Lh an | : oy 4 ’ } A ‘ ie ) /I a ic : Place of Deat! ’ ‘am Wife or Widow of “ a / ate of Birth 1 Years Se : ‘ala: eons R ‘ bid ; (Day) ear) or . Color or Ra . Date of Birth if £1 a SX Years Sex ee Color or Race aia Date of Death ae 1920 Age F ail Months § Single 4 6 , (Year) A ’ ait ) if (y,, Date of Death 1920 Ages <3. Months Single hat : ii Maiden Name i Yt Days Married Gee i onth) (Year) ah ‘ i Maiden Name A it ten Married Ged We Birth-place yee ae le. Oocunitien ee 3 : iba im Dull oo irth-place = ccupation | Name of Father His Birth-pl. hetcve & a Be ' Sey a ; : Ce in sta 0 Mercere” His Birth-place NL ae Maiden Name of Mother Her Birth-place fe Fil Maiden Name of Mother... 44<+422-@ 24-7, Her Birth-place memes 1a Cause of Death— Primar Secondary £ Desth—Pri Ss 1 ai Cause of Death—Primary Secondary HT Certifying Physician J. 4 Reader atindgaans “e Ca ‘ aid : : ae Certifying Physician Residence ta | Place of Burial Chem ery i ; Oat s / ah>w, a eee i Place of Burial 4 Cemetery / Funeral Service at . : a : : } : a ne eee a Tie. Put in the Diagram one mark like this Funeral Service at 61 ee CH_ Lot No. > » Di 8 ‘ i s ; If on ’ Pat in the Diagram one mark like thi Re Time of Service te 4 Grave No. or every Grave in it. And mark this Fy | for every Grave in it. And mark th / Burial with double dagger thus : ¢ Time of Service Grave No. B re og i oe Rs ei urial with double dagger thus: ft | Hh Date of Interment wid / of. Section ag : i if Designate site of monument thus: a Date of Interment / ee Section | , | | i . f Designate site of monument thus: ee aa ‘ L : nr aim : Casket or Coffin No. oO @.|| Candles | | (okt l i asket or Coffin Ott Ck car "750 Candle: Cinkss ac Calin Mx: Gojoe f3 fam © Le eel Cavities \| ' Size Made b : ye Size fade by Gloves | Siew id Made by | Gloves | | ini 1 Pillow Set No. 3 , | | t Lining and Pillow Set No | Bearers or I "Coetr Qs Lining and Pillow Set No.... Riaskce ce Gann | : | } F Ol a” t Handles | Hearse to AAA, ie ites eae \YV.2 ey Te | a 0° | Plate Removal ‘ r ; Plate Removal eo e | - : “ o BX & ive: LL ( oe) i ) | Outside Box or Vault Coaches “% L Y Ctstdn Cae oc Veale . Paachce CLO | Qa ew a Cay a oe : | fl Burial Suit Vero a ic if ct Joo | J fe | 1 Oe ail ( mm aaa Stoo Burial Suit f 2 ; a Slippers " 7 a Hhorikes A oe asthe = ee. Slippers nda _w1or ee flcecth 3 Newspaper Notices ' : ’ oy ty Ca JOO i me i Embalming he | a Embalming pes? I 0100 | ital Aidcaiien | } | / Washing and Dressing fal %.. ‘i Washing and Dressing | | | Shaving eae Shaving Services r Services 4 oosse ae o || ! i ‘ aco : ‘ ; , ‘ { Use of Chairs Transportation Charges ] Use of Chairs | Transportation Charges ‘i Church Charges | Officiating Clergyman VE ' Church Charges Officiating Clergyman i . . | : , oe i] Cemetery Charges | Amount of Bill LOVE } Cemetery Charges | 3 Oo Oo Amount of Bill |_/ /S ’ > oO Music | Goods Ordered by Music | Goods Ordered by ace / Hi tee | | | i Flowers Bill Charged to see | | i Flowers Bill Charged to | : ; _ a DR. CR. a und , 4 — 4 7 On. 7. ) CR. | | | | r | 7 BM) v0 at ba] Oa Sie ek] 758% Ga (Hiro Ni, CGeeea [Soa ae iL aw | (¢ , 7 Pe reat j — s 4 “ | . / aa | Ake af Not Fb } — i Ppsencninnal scares ipasenee x i { : - Yearly No. i Residence Place of Death Date of Birth Date of Death . Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment F an Voitids 2 Kaz KN ig Lee waht e /}# Ah Rc fekte 4 (Mggth ] (Day) (Year) 19 VO Age Cemeté Grave No. Section Casket or Coffin No. - 4 Aas, lant, ‘VIO Size Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Made by | | | | } J No ¢ bn ya C } | Mag fee Jf 190 “Kesidence ae, Lot No. RECORD AND BILL OF ITEMS ee THE FUNERAL OF W. 2 or Widow of Fe instill Years Y Months /).. Days Single BRLLE pye eh Rek Secondary Ck. aT Candles Gloves Bearers or Porters Hearse to .. Removal Coaches Newspaper Notices . 0? Wat x Officiating Clergym Amount of Bill Goods Ordered by Bill Charged to & os eek. Total to date Color or Race li Lebel { Married |... yle His Birth-place (Ri a “Her Birth-place @& PA# AL Put in the Diagram one mark like thi | for every Grave in it. And mark thi Burial with double dagger thus : t Designate site of monument thus: CJ Ce RAL Fea erect \ Yearly No. RECORD AND BILL OF FOR THE FUNERAL OF Lb Ste (Lktae f Lad hevw.— Carext, » Vaeece Residence Place of Death Date of Birth (Moath) Date of Death (Month) Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment ( Wife or Widow of Years Months Days Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. Grave No. Section ITEMS , Total to date s 5 Sex Single Married rae Color or Race Put in the Diagram one mark like this { for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate site of monument thus: CI Casket or Coffin No. Size Made by Lining and Pillow Set No.. Handles Plate Outside Box or Vault surial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. Candles Gloves Removal Coaches Newspaper Notices Hearse to Cc Aree Ck AL | Transportation ¢ Jharges Officiating Amount of Bill Goods Ordered by Bill Charged to Clergyman lc Sa rer eae eer SR rR acct in oe esidence Place of Death Date of Birth a Date of Death fet. Maiden Name E CL so ae fae | i Birth-place Name of Father Maiden Name of Mother Cause of Death Primar Certifying Physician dy # Place of Burial Funeral Service at Time of Service Date of Interment Casket or COffmNo. / Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges tse Oe RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Abin Total to date Wife pr Widow of lY. 19%O a Years Sex Color or Race (Day) (Year ann 1%O Age Months Single Sf, ED CBA. Days Married oo Occupation db eS His Birth-place ¢ yee fle 22 AL GY Her Birth-place ce Secondary ance Cemetery Put in the Diagram one mark like th | for every Grave in it. And mark ¢his Grave No. aa Burial with double dagger thus : Designate site of monument thus: [ ] “ee OO. Candles | “WE C| Gloves Bearers or Porters | Viaeexp Hearse to | | } | Removal \\ i : | Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Music Goods Ordered by Flowers Bill Charged to DR. CR. LaQ22« af Coeee r [D gael tildes cial | + ~ — ; | | id ee poeta | | —_ — | ad “ | ————— “a | i r ™ i {| nn \| & | | } | | | | —— j= | 1} - — ames . o | ' ea oasaiila a \— | - pian | sliahensitelin a - —_ - i 1] _ cena en sk | i] i! | cae ~ —— ene — me — —|| ~ | ———$—__—_— | slit ae i siccisiiiicnii cdubcaiil el celeniiok ie | | 1SOUED BY DORNTEE CASKET CO. BOSTON, MASS. 1018 RECORD AND BILL OF ITEMS Go Total to date... . FOR THE FUNERAL OF +N orca Aa, \leey jot Mare 0% Ca Asihe aia a ha. a — 7 Wife or,Widow of Ps se, AAahe Yearly No. Residence Place of Deat!s Date of Birth 19 7) f Years Color or Race (Month (Day) (Year) er date ) Oke 19 Age : Months 4 Single 4 é , i Date of Death i fe only fa gt ng j Le Maiden Name Days Married ty Lx Occupation Birth-place Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician my Residence Place of Burial 4 Sethe i isis fof Funeral Service at Lot No. | Put in the Diagram one mark like this one PSsccin Cavs ; I for every Grave in it. And mark this lime of Service yrave No. Burial with double dagger thus : t Date of Interment ae — or Designate site of monument thus: Cc) aa de 1% ; ; — Casket or Coffin No Lax (x5 Candles 4 |i “|e O Size Gloves | f @ds LF Lining and Pillow Set No... | Bearers or 7 ‘ —r Handles | Hearse to | | 0 0 | Plate | Removal i O a An Outside Box or Vault || '| Coaches 3 (Gr , / | we / O 0 \ | fioo| | : gp 7 0 | Newspaper Notices 00° Burial Suit | Slippens (recLe. Cren— | Embalming Washing and Dressing Sh aving Y | “hs ea | Se bre, | WS ia len pre La Charges 2) Officiating Clergyman | LPS Use Shore, hairs Church Charges Cemetery Charges Amount of Bill Music... | Goods Ordered by Flowers Bill Charged to DR. 7 CR. l A Ace | UV atl Te, ek _—_| 20 } | | ae i i i | | } i Se REERERER EEE eS Sears semannteernessoeroye poromaresmerty ee / ‘A! Yearly ‘No. Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mothe Cause of Death— Pri Certifying Physician Place of Burial ae i Od th Ad ea 7 } , , Funeral Service at ; £ Mi Time of Service Date of Interment Ee Casket or Coffin No Size Lining and Pillow Se Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flow ers DR. @ eile g Neca 0 fre tf (e™ Chery cz hte © an Occupation 0 Reth rer RECORD AND BILL a ITEMS ppbriitte > THE ” Tota/ to date ~ — lace AS mem “Ha Ch gi Wife or Widow of SS Years 5 (Month) (Day) (Year) : = 19 Months Singk Days Married ee veers s oe His Birth-place Lk er ee. ae CB a idles a het Her Birth-place CEL a co Le @ a Secondary Residence Cemetery Lot No. | for every Grave in Lt & Yi 20/tO Grave No. Section Color or Race — .— Put in the Diagram one mark like thi it. And mark ¢/ Burial with double dagger thus : Designate site of monument thus: { j ; Tides / VS.o0 O.| Candles {| = Made by | Clie Y t- rH t No | | Hearse to | Bearers or Porters | Removal | | Leasgpal lea fos Coaches Koes A_@ac- 5 F) Newspaper Notices On *Y §| 00, nee e Pets eM ger res LP (/)\s a | | / ye | C 1 | Transportation Charges J hoae fe Joo ay 19817 vd 4 re JA * Q Bo Officiating Clergyman (N10- F840 7 Amount of Bill Goods Ordered by Bill Charged to ed ial BOSTON, MASs. 1018 fi 19OUED BY DORNTER CASKET Co. 7 164 VWTre oY Soo 159 RECORD AND BILL OF ITEMS Yearly No. L THE som Or Total te date. Y Y € Residence — | Ov aA Place of Death OC Olerictu yo . fife or Widow of : Date of Birth Ary “Pf 1 iS we tts pe y Race (Month) 2 oO ) Year) ae Date of Death Qh 19°#O Age | Months 4 Single onth) +O ) Year) . QRAK. Days | Married Maiden Name ee Maiden Name of Mother Birth-place Name of Fathe: 5 yA Y -place hrcdere ©» ‘A er ,Her Birth-plac Oefadary be ZJatww fue Hesidence ,“ Lot No. Cause of Death-— Primar Certifying Physician Place of Burial } Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : f Funeral Service at Time of Service Grave No. Date of Interment armen Designate site of monument thus: te jpusemccictaienisiicstlNimaesaiiainliaitins a: Casket or Coffin No. Th 7S5e © Candles Size Made by I || Gloves Lining and Pillow Set No..... | | Bearers or P _ rs nz Handles | | Hearse By i Natere rant ln: Coin. § Plate | Removal vo ——— AVI 00 | Sf 2 fea Outside Box or Vault Coaches a vee Burial Suit ool i tS) Newspaper Notices pIO?e | | vo} Slippers i mbalming Washing and Dressing £ Shaving Services Use of Chairs Transportation Charges ( ‘hure th ¢ charge s Officiating Clergyman Ceme ote ry © harge s i | Amount of Bill i| 1 Music } | Goods Ordered by Depo B Q | | Flowers Bill Charged to DR. WW Win Vo Wer gp Gree | a “oma too s 2 Bn esd 10.0 | of ae oe et |. ae ; _| | | ee sipeamaeeas | | oe | | | | Re i | | | | | . | 7 me 2 ere wal i | a | | | Ce “ Sei ia | i bid ict sie wid ean biel Ga | | SES ee ee | | eee oa - _ | - - _ Ss q 1 bs Saree —| - 1 ——|] —________ ee — ( I sii - \- — fh ais sits 160 Yearly No. Residence Place of De ath Date of Birth Date of Dea th Maiden Name Birth-place Name of Father Maiden Name of Mother Cla t Cause of Death Primary Certifying Physic 0 Place of Burial Funeral Service at Time of Service Date of Interment Te Pi a Secti | | 2 Ae Occupation “on 4 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF * CA4A~A ‘> or ww of ny F Years x Waa Y ir) (Day) / 19 Age 4 . Months Single Married “~7 €/ His Birth-plac Mes Her Birth-place a ae > ro Secondary Residence Cemetery he srave No. Section Total to date. Designate site of monument thus: Color or ‘Race (tats Put in the Diagram one mark like th I for every Grave in it. And mark th: Burial with double dagger thus : CJ Casket or Coffin No. / / Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Nyx i LOCK Teo: 2.0)| Canes | Gloves Bearers or Porters | Hearse to Removal 4 ay / Coaches 0 C (tt UCcCeCo_ “AQ@Ray Ree ae, Newspaper Notices foo \—_{—____- O YI\O0 Transportation Charges Officiating Clergyman # fiw) Cemetery Charges ti Amount of Bill —_—— 3 eo e Music Goods Ordered by | | [ Flowers Bill Charged to i = 1 sheeted 'SGUEO BY DORNTER CASKET CO. BOSTON, MASS. 10106 i, RECORD AND BILL OF ITEMS Yearly No. xh fae (Prouth) Residence... Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother. Cause of Death—- Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment (fea tf FOR THE FUNERAL OF Total to date... Meovrse ff Wife or Widow of. / Se, MALe_ 19 Years (Day (Year) mel 9 JF ZO Age Months 4 Single ; (Day) ear) F Days Married €@2 Occupation ¢ - His Birth-place Grave No. Section Her Birth-place 161 a Color or Race aka Put in the Diagram one mark like this | for every Grave in it. Burial with double dagger thus: t And mark this Designate site of monument thus: Ci Casket or Coffin No. 77a jo i| Size Made by Lining and Pillow Set No...... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music. Flowers rAL4O YOO G Candles || Hearse to Removal Ps i Gloves Bearers or Porfé (Lrg ke.. Lea oe | Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill yy c ? Ts R20 fe Goods Ordered by . Mar Cte | Ae | Co ctae raat Bay, me ficmaa ue DR. Taek | Fee ..I} ; : sis | 7}. Oo _| fn ee | acai aa | | ae | _| | | a | | De | c | : ae | a sO — a nee en ~—— : - . _ | mM Z | ao ! - eal. Re uc: i rnin ; ii git a ee 4 ide ee Scilla anc . Aaneaereasnacttsncssiaenilacasines ne eOnGET see 162 RECORD AND BILL OF ITEMS Yearly No. 74 4 Doe, oot: Residence Place of Death ee Month ae Date of Birth Date of Death Maiden Name Birth-place - Name of Father B Maiden Name of Mother Primary“ } ea Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR Gi gllee Cor ne a me Occupation a eS igo Age (Year) FOR THE FUNERAL OF His Birth-place Her Birth-place C7 Total to date = . — or Widow of - YZ Years Sex i. Color or Rac € ~ Months 4 Single oe oe Days ACL: Marriec Secondary pont les ai Residence Cote, R@Q- 7 Ch-cimerery Yo ©0O Grave No. Section | | 5 We ho . j i] Put in the Diagram one mark like this I for every Grave in it. And mar’: this Burial with double dagger thus : } Designate site of monument thus: i ] “7 Candles Gloves Bearers or Porters... OD Hearse to _ I %¢ @+#— A ey Removal ih : CL Qa, Coaches , g iy 7 Pe Newspaper Notices ae Co f@ Co Si od Transportation Charges A Officiating Clergyman Antount of Bill Goods Ordered hy/ I Piero kk Val Bill Charged to 1SSUEO BY OCORNTEE CASKET CO. BOSTON, Mase. 1018 RECORD AND BILL OF ITEMS Total to date... FO FOR THE FUNERAL OF Gein ALB hex, “RO- fh. 7 KATZ. Yearly No. Residence Place of Deat!: Date of Birth ee_2 Wife or Widow of Color or Race 19 Years Sex Cement: - / tere, (Month) (Day) (Year) 19 Age Months 4 Single SEM, d (Year) Date of Death (Month) (Day) Maiden Name Days Married Occupation His Birth-place Her Birth-place Ghititiz. #6 Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : f Birth-place Name of Father Maiden Name of Mother Cause of Death (OD x Secondary Ca Certifying Physician YA by & — Fae ‘Ax _ or" ae C Cutler | Che Ae Cemetery Lot No. Primary Place of Burial Funeral Service at Time of Service Grave No. Section fh, , 2@ {re Designate site of monument thus: Cc) Date of Interment ) or. | | es — “| Candles I Size eee .. Made by Casket or Coffin No. Gloves Lining and Pillow Set No... Bearers or Porters Handles Hearse to Removal Plate Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges | Officiating Clergyman Cemetery Charges Amount of Bill Goods Ordered by Music Bill Charged to lowers SSUES BY CORNTEE 165 | 164 | ) _ RECORD AND BILL OF ITEMS | RECORD AND BILL OF ITEMS ga Yearly No. G [ FOR THE FUNERAL OF Tota! to date nat te son Tee FUNERAL OF Total to date. L3 : Moute Warts | att auoey Sharfia__. Residence } re Residence Place of Death Wife or Widow of | ies iis, are Lett ' Ga. Thos f2—wy or Wprow-ef & t Acetet LK erf_a.. ies cual 25 Years Sex 7€« Ca Ee Color or Race ) Date of Birth Lt Ch J 19 = ; Years Sex MB Le G yor or Race Date of Birth 19 - 7 ‘ . ae ao, Cie) (Year a2 LOHR TM. 4 } - : 19 ZO Age Months 4 Single SP py (Year) Date of Death ‘Spex ’ : 19*VV Age / Months 94 Single Yes - Fin ntfs ¢ UV, or y J Sing . ath day) ) = , , thteed (Day) / Fh WYear) > Maiden Name , ¥ Beer a Days Married LO oer ‘ : Da Y Married a ai \s ; Maiden Name | Birth-place te Moar bite Ae Occupation 2. | Birth-place IS ae ee. ee P Occupation (a ttwda “: wl 1 Name of Father / Chery Le WO bg His Birth-place <Leee & ALA. | 7 4 < ¢ oo ‘eho : Name of Father — . His Birth-place Gab fer *& I Af Maiden Name of Mother ele, oe. Xe ‘plac e ot rd i area) Pe L <4e CA y- Birth. -plac . hi oe rym, ; Yi : - ~ CRorg Cause of Death — Primary Secondary at o£ Ce dee - 4 (iceesiinailaaeail e i Certifying Physician oO : YY te “oa Residence / erasers anes Residence ae Cpe Ce KY ~@ ; : Certifying Physician a ; E . " As) it Place of Burial (ale, = Cerece Lo Cemetery Place of Burial Mar: ue @@eee, —" Cemetery i ee ne J ape (7 A like thi HW Eeenee Service at / Lot No. Put in the Diagram one mark like this Funeral Service at KSp Lot No. Put in the Diagram a ” 7-8 i T = ; | for every Grave in it. And mark this A“) <4 AO : Pr ae N | for every Grave in it. And mar! ; : ae gee Ti Servi pe . Grave No. Burial with double dagger thus : ¢ 4 Designate site of monument thus: le lime of Service i or oe i @ fA “—) i. Oo ve INO Burial with double dagger thus Time of Service 4 214 d J Date of Interment / a / 2 Section ii Date of Interment A / Section : ee Designate site of monument thus ate | | | ' 7 | Hi - a — —— — — prea I ea ho ‘ | - Cc O\O Oo ‘s > } 1 i Casket or Coffin No. y ( Ody Ja e Oo Candles | Coils ot Colle ie” Te Tia / ~e A= 7G) - Candies | ‘ | Size Made by Gloves | Size ; Made by Gloves | ; a, I ee { } Lining and Pillow Set No I Bearers or Porters I! Lining and Pillow Set No.... | {| Bearers or Porteys, a - { - | i r ae i ; ( Ov (LLG te = fV Pa sf H i| | | Hearse to é 7 H j andles | Hearse to ..... Handles : | ; | 4 ay | } || i / Plate | Removal || Plate ‘ i —— - | a . | ps I ‘ | | Outside Box or Vault Coaches i Outside Rox or Vault Kj i| 5 | Coaches + H : i 0Y i J ait Burial Suit | Burial Suit ms ere | o OPc ji . | | ) Al she A te— | »wspaper No 8 Slippers Newspaper Notices i] Slippers . / 7 Cf UY) ‘ i] ae | Newspaper Notices | ee | } ly AL yteg || 0 | af Embalming | embalming / / | ii ; j : Bh Washing and Dressing | Washing and Dressing | | I : Shaving Shaving i | ae Servi Services | > ices 7,ervices | | ; : ee , es } | ‘Transportation Charges _ Use of Chairs Transportation Charges | j Use of Chairs I “I | {| Lointine Clerevins i Church Charges Officiating Clergyman iene i Church Charges | | Cmciating Cacgynen f C 5 Go | | | . i) - Cemetery Charges Amount of Bill , ee ere : | | Sa ag 4 Lk O4-f ; 7 : 2 ; - i] . : sed d Mag x c m Music | Goods Ordered by A. Ltaet, (4ae Music.......... oe | Goods Ordered b} if. Pee , i | | ‘: | i ‘harged to ae ; Flowers Bill Charged to ¢ : Mowers cals i ae A L - i: CR. DR. CR. DR. r) : l p ja q , ; i, ney | Ky | | | | bel SO Cork / zA— | Jean ice ee een ee - | p. | ais i | | “| | fy | me | 2 | | | | | ee _ ag ie H Fy “| | 4 | 3 asf poe -|| | L | ~ | | i | Ht i | || } ‘ \——} | | | | | i} | | \| | | | { oi | ] | | ; : ) = | ee | i | - 385 | | | | | | = | r | | 1S8UEO GY DORNTEE CASKET co. BOSTON, MASS. tote 166 | i | » ia . a RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS foo Total to date 4 Yearly No. 1s Aer yf FOR THE a ; Total to date sae se FOR THE FUNERAL OF si ask. eer t — ee a { Yue. E Wi a Residence aly. - i r Widow of Place of Death ife or Widow of | Date of Birth ? (1 19! 4 (ile hele Place of Deat! 7 — bn v ~~ ‘ f Bi iw 7 O Years f Sex J Mle Color or Race (Day r j Color or Race % (Year Date of Death Uta wi igvO 4 <2 y fc : f} Wi , S Date of Birth Ag Months ¢ S | Year ‘ Month D (Year | onths 4 Single Date of Death 1970 Age 7 __ Months Single , px (Year) qe 7 i } / % Days Marri ) i Maiden Name al / y Days | Married v | Birth-place MeLee sz Le at c : {! p Occupation lf Fr _ Dev 2 C “ke : n f Father Lo - ey KOLAR hese G ae co Birth-place f. Occupation a2 fe. Name of His Birth-place Oe A ; . a fa He - ) wo ' Maiden Mi f Mot! Bie ey A KD Kh Name of Father EDM L LA KHIR LA A _ His Birth-plac gece n / aiden Name of Mother Her Birth-place ae e SL: C2 LU Ate Cc, A . : Cosas of Dest Po Maiden Name of Mother akith aeg L Oe Birth- -place @e. \# 2. | tause of Death rimary ae Secondary Certifying Physician Ay qd e her Rercee, Tv dy CP HS ence Cause of Death — Primary dy ass C Secondary ‘ ae : : : vertifyi sici¢ 5 bent. = Residencé— 9 } : j Place of Burial Ww V9 VU 4ew Ch . gL Certifying Physician ad Me sie Bat traat Coffee ae Residence eq Maiden Name ~ Place of Burial Funeral Service ai Lot No ( _ pee Put in the Diagram one mark like this F ] Service at Lot No. i i Time of Service f Grave No. | for every Grave in it. And mark aa Sagara ~ ee ae eo Pe Burial with double dagger thus Time of Service Grave No | for every Grave in it. An 8 ¥ e Date of Interment } : “se Section am Ee ee ee | j , Designate site of monument thus ‘ Date of Interment Section | : ‘ i : | | ar C ro Designate site of monument thus: [ i fe . ® + 4 i f Casket or Coffin No t a A r O OOo Candles | oa a: Le — : | wi : Casket or Coffin No... ¥ Ke45 We5 O2\EO. Candles | ; _ Made by Gloves i] s a : i i Size Made by | Gioves i aning and Pillow Set No 3 or P. rs : | | ie Bearers or Porters i 4 Lining and Pillow Set No... || Bearers or ee rs i | andles H arse to i i i] be | earse Hendlas || Hearse uh BegraetSAT 47 ae ~ oo } late | : 1 {| | : Removal Plate | | Removal VP 2 Le. fa Anny c,.,- Sr Outside Box or Vault por | pic Coaches Outside Box or —? Py ! Coaches Pee © aan urial Suit i| 4A lo zl “OTS - ae 3 | Ve Burial Suit LK e \] Fé OO “ef - 5 oo Slippers } Newspaper Notices | Sli ; | Newspaper _. n re 2 | Slippers i} — Newspaper N6t}ces tL4-s Ce ..s : Embalming E : “e . | J 5 Sas no i 44 : tat | “embalming | / > Eo . } f W ashing and Dressing } . b r Z { ( / Cas b- 7 aay Gs a / Shavi 8 Washing and Dressing Ve ‘Be : \ f Cu» 2 & i i Shaving | . | : © Shaving = | \ / Oo | Services | 8 | | ; 7 Z Services f z tg $100 4 Jse of Chairs Tvs — : = v | 8 Transportation Charges Use of Chairs Ae ae nage i Transportation Charges Church Charges 5 tal . } ¥ Officiating Clergyman Church Charges | Officiating Clergyman G Charges 2 De | - | emetery Charge - "a Amount of Bill a e C2 Cemetery Charges } 7 e e | ae Pe A, We ' Music Goods Ordered by Lite Meco. ot . Muaie | | Goods Ordered (Ag her ¢ ete dite 3 |e © | / Flowers } ; | 1 : ! Bill C “ar fio - ete Bgl | i Flowers | Bill Charged to ee a ; 7 DR. (a 7 . . i ee CR. DR. _ CR. lap > f | 1 ORL |: 0g Cow ] | Ah és | | x < 0 kL | my att = | 520 Ff (Ley 6c I au 2 OC 2 i L is ~ en i] — pa 5 > _— aw of. - | oe os il Leg? | ec cies : a | a se | } n | i ane i | ih | ' 1 | 2 | | T | ‘ _ i | — - | i i | . | inne I a mene eee i ss al | } | eet : mee ‘| | | |——— ! | sabia : Sai ii | | 1 —_— - ' | | I — | . 4 + ~ ne | eens aa ane —— Le AT cE —_- | i} | | | | _—— ~ } . \ j ae ce | Peet Ea ee — | —_———- 8 — socal (oii : hii iin oe nese: senate | * | iH } } | (SOURED BY COANTER CASKET CO. BOSTON, Mage. 1018 ¢ a | | 5 iH BY a] einem ete an OO i NE ATO Bitte ache 168 \ (2! Yearly No. PY, | RECORD AND BILL OF ITEMS FOR THE FUNERAL. OF her fo Qyyay Residence Place of Death & Date of Bitth ) Month Date of Deg Maiden el Birth-place Name of Father Maiden Name of Mother Cause of Death Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment scene Casket or Coffin No Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Chureh Charges Cemetery ( charges Neh eA 19 O AC (Day) (Year 19 Ons tte, (Month ee, = ) Of e% (Year) Wife or Widow of f Years Months Days Oce upation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. Grave No. Section 4100 patents Candles Gloves Bearers or en Hearse to erie Removal? 7@ v1 Gere 00» Vo20v% E oS | Sé Tota/ to date Color or Race Put in the Diagram one mark like this I for every Grave in it. Andn Burial with double dagger thu k this C Designate site of monument th Shes, Bu. bag 6 Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Music Goods Ordered by Flowers Bill Charged to DR. A : : CR. panne - , — ' |_| Mo@eex Lote |—7720| A rol ive Kee wT 39) | | t 7 ne —t | | | a | i| “| | } | | | | | a | | | J | | d ae 7 ai la a Se i aoe — a caiman ! | | I | (S8UEO BY CORNTEE CASKET co. BOSTON, MASS. 1016 7 Teo RECORD AND BILL OF ITEMS Yearly No. oe Kfnert ete Residence “ Place of Deat!: Date of Birth Date of Death M2 >” Month) ay) Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment nerinevesrraniaies: Casket or Coffin No Size Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. 7 ogee . Je wer (te Le / _ 1SSUEO BY DOHNTEE CASKET CO. BOSTON, MASS... 1810 he) (Year Le Age 19°24 FOR THE FUNERAL OF Se. Yh Wife or Widow of Years Sex Months 4 Sing (Year) Days Occupation His Birth-place Her Birth-place Secondary Residence Cemetery le Married Lot No. Grave No. Section w * Candles Gloves Bearers or Porters Hearse to Removal Coaches New spaper Notices Transportation Charges | Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to ed ie | | 169 for 9s Tota/ to date Color or Race Put in the Diagram one mark like this 1 for every Grave in it. And mark this Burial with double dagger thus : f Designate site of monument thus: CJ SL SE IR i EP ara Ronee a 170 : . RECORD AND BILL OF ITEMS at FOR THE FUNERAL OF he Dove CLtuy eee hie G6 err on) lok: Yearly Wo. Tota/ to date Residence Place of Death Wife or Widow of , rakt Date of Birth 19 : /... Years br or Race : Le a (Day) (Year) Weg , Date of Death a de 19 Ww Age Months § Single Ok 4 Maiden Name , ; fn f Days Married — ic Birth-place Ye £ tok... ee Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. > . Put in the Diagram one mark like this Grave No. | for every Grave in it. And mark thi Time of Service Burial with double dagger thu Date of Interment Section Designate site of monument thus | ] 0.1) Candles e Casket or Coffin No Coppa br Ley | Size Made by \| || Gloves Lining and Pillow Set No Bearers or Porters Hearse to Handles Plate Removal Outside Box or Vault Coaches Burial Suit Slippers | Newspaper Notices } Embalming | Washing and Dressing | | Shaving | Services | Use of Chairs | Transportation Charges | Church Charges Officiating Clergyman aa Cemetery Charges Amount of Bill j ©.) Music Goods Ordered by Flowers | Bill Charged to DR. CR Pali | Ceu0g | | selo Jo Mriet Wale, \oloo, {SSUEO BY DORNTER CASKET CO, BOSTON, MASS. 10186 171 RECORD AND BILL OF ITEMS i Total to date.—‘ Yearly No. FOR THE FUNERAL OF ae 7) Q, CY & wetl i. Residence LR a rhaeee Y Place of Deat! er UJ AL ‘ Wife or Widow of F el —o ; ae Years be f - ) co (Pty) - Cy Date of Death ‘ 44 Oo Age Months Single Date of Birth £' oth) (Day) (Year) Color or Race Days _ Married ‘ id ef 8 a da © Ve Occupation o> Me, FF Colle. bbe per 4, AQ CLLR? LLY ¢ or... His Birth-place & aref ACe aty~ Maiden Name of Mother...) MWe Te \~ Her Birth- -place ve us Missae hike jeilillidiain F ‘ pe LU Ari, Reside a Aovg wer fr Ae Lo- 0 . i. aiden Maiden Name Birth-place Name of Father Cause of Death— Primary Certifying Physician Place of Burial O OM etery No. Put in the Diagram one mark like this Grave No. | | for every Grave in it. And mee this Jo40- . te ofa, O Burial with double dagger thus: ] Me. Secti 8 | a | Designate site of monument thus: ~~ aga es Candles Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size Made by Gloves Be arers ofr Po 7} : + ab Cocece Ze Hearse to Removal J Ke le Foie ay Coy-f- Lining and Pillow Set No... Handles Plate , Outside Box or Vault i} Coaches Lot Ran; NS O New spaper Notices | j | | Burial Suit Slippers Embalming Vey Uce@ a > Washing and Dressing sage Use of Chairs “See Shaving Services Transportation Charges Church C sharge $ Officiating Clergyman \| J L > | Goods Ordered by | Cemetery Charges Amount of Bill Music Bill Charged to Flowers ee cast sane swore ons DR. F | [0 18, Roce. PELE a / | | | Ba | | | : ’ | | ; | =a | a. | nc a | a i | ES eS | E 1 : joist ie Maecs ae a | __aae I | | bas - 172 a js j FOR THE FUNERAL OF ture (ack, a f = ? , a { AS Wk ot fe V Jbl Lk te ec, xf C Lk h- 4s ee. ommend Groin of oa . Sex Z Q Ke Yearly No. Residence Place of Death Date of Birth sess - 19 . Years (Month) (Dey) (Year) Date of Death yp ‘: 16 , > “ Age Months 4 Single y b) (Day) - (Year) Maiden Name if Me/ — /¥ a Days Married SL ¢ yx t 2 RE Occupation Add, Mack His Birthplace LLL Rep her Birth-place Name of Father Time of Service A24+Ch Grave No. RECORD AND BILL OF ITEMS Tota/ to date Color or Race , | Me @) eS Maiden Name of Mother ‘t A Nhe nth an. Her Birth-place ZF wh cee. 4) Cause of Death Primary its ‘ Secondary WY Ad. Wat he eal Certifying Physician ff ™ 8 A Residence . C2“, a / j ii # < / Place of Burial A, { { & AL. e t Mr Chrpy j Cen ters AL. Funeral Service at y pT Lot No. Put in the Diagram one mark like this And mark ¢/ Burial with double dagger thu Designate site of monument thus ae | for every Grave in it. Date of Interment (VA { a ‘ue Section a naan | Casket or Coffin No LMA uy Oc C..!| Candles Size Made by j Gloves Washing and Dressing | Lining and Pillow Set No | Bearers or Porters fi Handles | Hearse to € EE Plate Removal Outside Box or Vault Coaches Burial Suit | Slippers | } ewspaper Notices Embalming | Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Amount of Bill Cemetery Charges a Goods Ordered by V cK tALs Sarees a4 Ja elo. | | j | | ia —|- i (SBUEO BY CORNTEE CASKET CO, BOSTON, MABE. 1918 Music Flowers Bill Charged to DR. rane 3 : as i CR. | FOR Ate, | wo Hool Me Wwhh Rt ku cad ie & | | | al low ~~ | sfeso i ; |~ | Bre in Garr = tesla | ean he RECORD AND BILL OF ITEMS FOR THE FUNERAL OF 4}) a ‘\ heey khe js WHette ubus A? ee 7 “—; Whlaw of oe Tota/ to date f Yearly No. 4 ‘ lke Ah, VAL Che Residence bveke Hh hi fl - “2 CU? ££ 4 } ff f llliud. Place of Deat!, Date of Birth if as Z Years Sex Ch Mk Color or Race tla. (Day) (Year) S Date of Death Qs. on 19 2 O Age Months § Single / ¢ ee er 4) . (Month) / ‘Soa im %0 - “) : ‘i . f Af, a Maiden Name. /h~ige@eum (fice fleu * Z Days Married (/€.1/ ao : . . c . Birth-place yr. £2 6.0. G £. A {. Occupation Ml Ried K. Men Name of Father Ta Lh &+ Tec His Birth-place phe Lek —- U2 h_A— yy, d Maiden Name of Mother « (id a..& Her Birth-place te - Cause of Death— Primary _ me Secondary Certifying Physician yh ¢ . C2 Kae R244 Residence “ t, Place of Burial NAM, i Ag (Leese Bonerery Funeral Service at ‘ FARE “nN Lot No. | Put in the Diagram one mark like this Time of Service D..8 Grave No. teal wi decker ate Date of Interment ” 4 / f 4 e ~ Section | Designate site of monument thus: oo > Casket or Coffin No. Vy way ‘ Size Made by Ic © © O Candles | Gloves Bearers or Popters l Hearge to % Lele VA Lt 4 eX } -" Rep Ohl (24 A/c AC £>f Coaches {| Lining and Pillow Set No.. Handles Plate Outside Box or Vault Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing i Shaving Services Use of Chairs Transportation Charges | r Church Charges Officiating Clergyman | ; . Cemetery Charges Amount of Bill | 4 4) | Music........ | Goods Ordered by i ' Bill Charged to A EA TO IEE RT ~ 2 AE SOR I EE I Flowers DR. Ce ener ner aNT RT 174 45 Yearly No. 7 Un ay, Place of Death Residence Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. We ea ae RECORD AND BILL OF ITEMS (ks; “Si aaa OF 0 fe / | 19 (Year 19 Wife or Widow of Years Sex Age Months 4 Single (Year) Days _ Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. Grave No. Section Candles Gloves Bearers or Porters Hearse to .\ LALETE. Removal ( ‘oaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to | Total to date Color or Ras t Put in the Diagram one mark like this | for every Grave in it. And mark thi Burial with double dagger thus : 7 Designate site of monument thus: C] {SSUES BY OCOANTER CASKET CO. BOSTON, MABE. 1010 RECORD AND BILL OF ITEMS Yearly No. Residence Place of Deat!: Date of Birth Date of Death “2 Maiden Nani Birth-place Name of Father Maiden Name of Mother Cause of Death—Primar Certifying Physician Ji Ook k {N64 Funeral Service at Place of Burial Time of Service Casket or Coffin No. Size Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Ashe Wat ~ OR THE FUNERAL OF Tota! to date ees , wae 4 [Bw ra ¢ th Ig Years Sex oa Months 4 Single Days Married lil Lk, hdd C lof Residence wk ate Cemetery ee Lot No. | Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Section | : ! ‘@ Designate site of monument thus: | Occupation His Birth-place Her Birth-place / Secondary oa) ee Vsve QU A Grave No. Candles Gloves Bearers a Hearse to ——* Removal Coaches Ne ie , # Lstf VA, i CEL Transportation Charges | Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to DR. here I, Ciuto{-~ — 176 ‘ 177 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS Yearly No. !2O FOR THE FUNERAL OF Tota/ to dat. ” = — Yearly No. FOR THE FUNERAL OF Tota/ to date BS Nay 140 Xf Clie c KLee é Chal re « 4 Ore. tre Residence AL Oa id Resid Place of Death /¥ C2 2 22 — / Wife or Widow of | neg oo ‘ ‘bee re se ; Place of Deat!: D4. <4 Wife or Widow of to &. A) : Via) Maiden Name ; Birth-place A Occupation : Q@ ” - > Birth-place . : Occupation CO ‘ Aaa ae / Qu A Le V i. ee ot AL tpt Leedt. Ce | ecup . a 5 Name of Father sco yo His Birth-place iti or Poe, WY r A < a - = ee iG Ce 10 2k Be a @ a_{ CL 22 eA. Her Birth-place | fd ne, : eo A_& Mt 1t/e r i Maiden Name of Mother...‘ re rn A_B-4+— 40 Ver Birthplace Ft he SLL — iP ; Cause of Death — Primary , E ABM Secondary : C £ Death—_P 3 i + Bd BQ 2 Cause of Death a J Secondary Cer , Physici: WY A ita te é ertifying Physician a Residen Coctiying Pliysicion y # A_@_e e » il 4 ot KN A ATA A Cemetery . Be: oY t £ jc & ’ Place of Burial tev R_-4_2- A—Cometery on Date of Birth ean v’ 19 20 Years Sex J 7 ; Color or Race P ms y , G A 2 2 ms EA 4° y Le | Qt = Date of Birth LLLR w/e Years Sex ; —— Color or Race Date of Death - y 1920 Age Months ¢ Single UY kL Ca / A ae L4eg; eT Month (Day) (Year) BS 4 — —_ 1 id re Date of Death 7 2 ic 19 20) Age ed _ Months 5 Single Ge A DD : Maiden Name ' 3 Days Married Month) Year | + . ) 4#C’/.. Days | Married a Maiden Name of Mother Place of Burial Funeral Service at / x fe ah or No | Put in the Diagrs 1 } . tee” co Gan CL : ut in the Diagram one mark like this ' Funeral Service at mere r Lot No. Put in the Diagram one mark like tl Time of Service ) OU Grave No I for every Grave in it. And mark thi : / eee | : ( - : "- 4 k “vd ; « ] : DG Pe Burial with double dagger thus : i Time of Service / 7 5 Grave No. J Ses dpsed ai ; eas anit rte D: te f | te y t f : { mae o er Sec i : . ( @_ ) e sae ” 4 Sore ) 1; ce a Designate site of monument thus: [ ] Date cf Interment Wt i / ‘ U Section | | | [ | Designate site of monument thus: | i / | : ne _ “ 7 i ; si } / | ; T P sia a / Casket or Coffin No. V e / 4N..©.' Candles | j Casket or Coffin No. a i e.. Candles Size Made by Gloves | Size Made by | Gloves i ine and Pillo ot N | | i cee ana j ‘oc oT ~ Lining and Pillow Set No Bearers or Porters | 4 Lining and Pillow Set No.. Bearers or Porters i| i| 1 Handles Hea:se to .. Handles | Hearse to i Plate | Removal Plate Removal } } | : j } Outside Box or Vault | Coaches i Outside Box or Vault ; VK pe Coaches Burial Suit | lurial Suit Kye vf uth haz I> Lo . . Hy r | Slippers | Newspaper Notices Slippers Newspaper Notices | Embalming |! i Embalming se le O Washing and Dressing | ; Washing and Dressing | Shaving ' Shaving | | | | i Services Services . i | . } | mm . ‘ | i Use of Chairs Transportation Charges | ] Use of Chairs Pransportation Charges ‘ ee Church Charges Officiating Clergyman Oi Nee EN i Church Charges Officiating Clergyman Bk | Cemetery Charges Amount of Bill / 2 Ve i Cemetery Charges Amount of Bill S - ) \) i f/f 1 a ee Music iH Goods Ordered by te Seygtm: t Music Goods Ordered by ~“ hte. fe Pe) a/ > | | | j f r Flowers Bill Charged to Flowers Bill Charged to i E i kar, ©@€A ‘ A t " an LSS . 1. DR. CR. j DR. i _ CR. - : oni " iia cian “ wr | | | | ’ ; : Se - j e- ; - ee ge rr cman | | ‘ a c / i : | Le Oruny Krer | we es ay 1 CB mee OL Gost. fxve2 ’ al O Level Cree Xb bv SEL, Yy Reet bathe *"~ | Yaoo i | | : Y Sh oo 7 t ete 5 ae Now/ 20,090 a | — — —— —— + ; en | 4 Uf j ; f Bera ; | | gE Ae (op NG Mh S5SO | ea ee | A \* Sa | ee i | LN "ae ee A = 4 | | | eeheeky —| en -|- “| || | ‘ | ] } | ae i ' iid | | | | | | _ | | ' } \| | } = ' _ 1 — =i _ - —_ 1 _ — * ‘| - + | -—--|— “a ~ } j | | —_—_—_—_ on | | o _ “ | —+ Ocala —4|— “ —{]| | —-__} - ia anil | ten nm a I ISSUED BY CORNTEE CASKET CO.. BOSTON, MASS. 1810 178 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date Yearly Na. (48 vy ; 3 LO ¥f Ke /e te an, J ear Budsete, Re Place of Death {+ Residence Wife or Widow of f Ia Years Age Months ¢ Single \ Days Date of Birth 19 Color or Race Date of Death har”. 3 oe ve Co %e/ 7s Oa , aes Maiden Name Married Occupation His Birth-place Birth-place Name of Father Maiden Name of Mother MN. SN Maney & $<L000 Go ao Her Birth-place Secgridary Cause of Death— Primary U Certifying Physician Residence Place of Burial O Funeral Service at Cemetery No ‘ . ti Put in the Diagram one mark like thi [ for every Grave in it. And mark ¢/ Time of Service Cen Si: Burial with double dagger thus : Date of Interment —- a \~ 0) Section eS Designate site of monument thus: CJ Casket or Coffin No. Candles Size Made by A Gloves | J] i] Lining and Pillow Set No % K/ || Bearers or Porgfts | Handles t Hearse to Plate ‘i Outside Box or Vault - Ss Burial Suit coe .. i) ‘Ss Slippers \ \ i Embalming b Washing and Dressing ' ; Shaving , \ A Services Use of Chairs . i /A\ i Transportation Charges : Church Charges \ \ Officiating Clergyman ; $F Cemetery Charges Amount of Bill. , j ee ro j / || Vi, / ) ~s Music ; me Goods Ordered hy /.A4_.4 | { KE F Flowers Bill Charged to DR. CR. bd F ieliiesiMicai all = onediens | PT |) ——__—__—__;----+ | {—| -ilelapn ill oat . = ISSUEO BY OCORNTEE CASKET CO, BOSTON, MASS... 1010 179 RECORD AND BILL OF ITEMS Total to date. / f o< FOR THE FUNERAL OF AH. le ncdhe dAt«- Yearly No. Residence Place of Death Bes Pin: id ae _ eS by Gst | 3 eX J BQ Color or Race (Day) SY 19 ‘tO Age / Months 4 Single i ? } Days Married “ f&4 2% Ze (Month) (Day) (Year DQ Ax ‘Occupation is Birth-place g VQ TV he ee ed, (cee if RA Ser Birth-place Ww C2 Re. ae . A C/ Secondary Cause of Death— Primary wy Date of Birth Years Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mgt Certifying Physician i Residence Place of Burial I~ Cemetery Funeral Service at Lot No. | Put in the Diagram one mark like this Pi A Maccinn Cox ia | for every Grave in it. And mark this : oe Burial with double dagger thus : Re Date of Interment Section ; Designate site of monument thus: Cc) co >. See iii CC —— Casket or Coffin No. c— 7050 Nae fhe, (00 Oo oO Candles Size Made by | Gloves ' Bez arers of P¢ ers jn VoL t/ fend ised | 25100 Lining and Villow Set No. Handles Hearse to, | Plate Outside Box or Vault Burial Suit Js@ {52 | Removal Coaches Slippers Newspaper Notices Embalming a Jloo| Washing and Dressing i | Shaving i | Services | Use of Chairs Transportation Charges Church Charges | Officiating Clergyman ; Bo Cemetery Charges i | Amount of Bill es a LIS. F\3 O Music } | Goods Ordered by ’ (COE ac Flowers Bill Charged to . DR. a Ae : CR. . WZ. } 180 x RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS Total to date OSE HS Yearly No. | 4 FOR THE FUNERAL OF Total to date. Yearly N early No. FOR THE FUNERAL OF Chu Ao+ Atta, : Cn. ta Go00 Dele “shit Zaruue lef ae eee a eelen, hr ; Residence Place of Death d VA ceo wa — ( Wife or Widow of 2 Pt £ Deat! Es we ‘i : “ ace 0 eath om , ile or 1d0w 0 Date of Birth A 7 =~ 19/ tun {tn Araer “ om 8 “ see y / Se ‘ lonth) + a “y — Son (Lis on Ra Date of Birth 7 Se 3 { ae Sex @ Ce Color or Race | i ‘ 19% Ave s ¢ Si " : 3 (Year) { . if (Momh Dey) (Year) BS Months ingle Cree : Date of Death ZL 2 19% Q Age 1 v Months ¢ Single ~ : i Maiden Name . ey las Micha Cie ate ia He er : Days | Marrie Z i . Ce FLL Occupation C7r- "7 j } H 181 Date of Death Tf Days Marri 7 - / ays farried i Maiden Name LO Birth-place ¢ — , 7 | | - so | Birth-place Or" Occupation / r Name of Father d hn, His Birth-place Ve Leee Co RL ; > tee tar pla J ean . - “i “ 2 ' Name of Father Abner Uuty—, s aa Cr Gy i y Her Birth-place aiden Name of Mother Maiden Name of Mother er Birth-place Niet ini ol Wiidiian Secondary i} ae Cause of Death— P —— Secondary C ¢ Death_—_P te dy er Jause of Dea rimary Se ‘ aul Certifying Physician J Carlee Residence ere oes : 7 C Berke r harried oe ; Hy, ? 7 Certifying Physician Sidence it ace of Burial Cemeter 2 oe _ Hi Place of Buria / emetery Place of Burial — Cemetery Nacerel soe Xo. > ike thi Put in the Diagram one mark like this § for every Grave in it. And mark this Funeral Service at Lot No. a ae : i : plea Put in the Diagram one mark like t! } Funeral Service at Cc ' | for every Grave in it. And mar} yrave INO. oa! T: f s Burial with double dagger thus : i Time of Service } ; : rave No. NAAAAL / 7 oO Sect; 47 - j Burial with double dagger thus : ¢ j / section Designate site of monument thus: [ ] Date of Interment 2 Qo Section | 1 Designate site of monument thus: | . Time of Service Date of Interment Casket or Coffin No. oR ” 7 190 Candles Casket or Coffin x dap [ OGoo Candles Size Made by Gloves Size Made by | Gloves teen seers ve amen —e7 Bearers of Portersy 7 - 6 CK BL } } 2a Tse f * 4 Handles Hearse to’ =: / Handles Plate } Removal ‘ : Plate Removal es | ee Oo, | / ~ face (dome) Sons ¢ >; Set N ss ; Lining and Pillow Set No Lining and Pillow Set No.. Bearers or Port - 1 Hearse to } Outside Box or Vault "Op neh ae } Outside Box or Vault | | Coaches } : ff ' Z ; o - | f Burial Suit "VY nt AML | — Burial Suit | nik Ti ‘ak, VEth Lah A, | = i} i | Slippers Newspaper Notices f CHIN AML ‘ Slippers H | Newspaper Notices Bey ; 2 Embalming {| Embalming | 75 0 W, Pe ] | a Washing and Dressing i Washing and Dressing 1 aoa i a | Shaving .. i : Cay fi. o ofp | - B92 | i Shaving | i : | } | ' Services Services ] | Veo nny Po Use of Chairs Transportation Charges Use of Chairs i Joo | Transportation Charges . ; _ . ec i Church Charges Officiating Clergyman a Church Charges | Officiating Clergyman , a | i| J ik Cemetery Charges Amount of Bill SS \,—_ —- Cemetery Charges i} O oO} Amount of Bill : 3 poo ; Music Goods Ordered by é (le A Music ‘ | | Gaods Onliend bi MB Lu. nal VY Mone K Aas 2 7 | a. | Flowers Bill Charged to a Flowers | | Bill Charged to ae ahemeeneen — mae niet’ menace DR. fr. DR. , CR | _|V@eeeek &f Ge, | F7%po} lA We. ase 7 : eres . wz , * | | L OLE ee 4 Gog I" f teeth tek Ae Ree Praiire a Qeeenrhece pres, Barns Ke of : WV > / ie 7 || J : } ; | | ae Ee en nNOS | j ARNT enna ' i i j ' ‘sea ae ) i ‘| \| | “i | f : | | | | | ee - | | — | ——_____—____ | ; | | | | Po oe | | } ; | j . i | iain | 2 si a = i a — = ta : fe Bae {- ‘a | | Sj | | cilia ke ISSUED BY CORNTER CASKET CO. BOSTON, MASS. 1810 ISSUED BY DORNTEE CASKET CO. BOSTON, i eineanaSRP Emenee pe 182 jJ RECORD AND BILL OF ITEM net i OE, a at Residence 4 Place of Death Date of Birth Month Date of Death Maiden Name Birth-place ee Month) Name of Father G Ceres Maiden Name of Mother Cause of Death— P ee Certifying Physician Place of Burial ve Funeral Service at Time of Service Date of Interment 4 J Lee FOR _ ins: F- Casket or Coffin No a Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flow ers 1927 (Year) Igo Age (Year) Ages Secondary x Puuncier Lot No. Grave No. Section Jog x FU / cece i ia pepe AL OF Wife or Widow of f Years Months Days rth-place sex Lebee_ 7 | hte —~ 3 Candles Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to be, fe | Tota/ to date Color or Race Put in the Diagram one mark like this And mark this Burial with double dagger thus | for every Grave in it. Designate site of monument thus [ ] Peagise ; | | | | Q [Yea fel] Cama] ho aad | | nl | | | | | | , | | | enna 188UEO BY DORNTEE CASKET CO. BOSTON, MASS. 1016 RECORD AND BILL OF ITEMS Yearly No. Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father. Maiden Name of Mother“. Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Lt ok FOR THE FUNERAL OF = Mes. Ma LL ce (Year) 197 © Age (Year) iv/@C f ; J Coveapaion *—*¢~ His Birth- -place Vr lk ter Birth-place — of Years 7 (7 | Married Days Secondary AbeKeame, Orbs ~ Cemetery Lot No. Grave No. Section sex HO Le. // Months ¢ Single _¢ f <4 Tota/ to date neat iain . 183 lc Color or Race Otm:— Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate site of monument thus: Cl] 2 47 OALaA | Casket or Coffin No. V (LR 42 i ““O'2 2) Candles qT | | . Size Made by | Gloves Lining and Pillow Set No... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. Mina d (sec Bearers or Porters Hearse to | Removal uty qe ac } flare Coaches Newspaper Notices “~ Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to Al Tay Ae CK, gt. Senne. eu - he ti WV Cay / AL } of. ra / VPA HX A a yerins 5 7 ee | +e a HY let 4 a. ay J sae 3 2 obs (S8UEO BY CORNTEE casxer O., BOSTON, MAES., tere 184 Yearly No. FOR THE FUNERAL OF hee ee Residence Place of Death Te Cae soi Le | (Day) pu (oO 19 F Age Sex {/ Months 4 Single Date of Birth Years Date of Death Maiden Name rf Birth-place Name of Father His Birth-place Maiden Name of Mother eA Lated ne Hy Certifying Physician f KA dk Hf : Place of Burial oy * vag if Her Birth-place Cause of Death P A Secondary esidence AWemetery r Widow of Egetsed 2; x Aa2L0, ; (Year) Z rk (Gta a Waa Be eupation 4 Re f ha (] RECORD AND BILL OF ITEMS Total to date Color or Race (22k Lot No. Funeral Service at Time of Service } Grave No. (LALLL_ / Date of Interment 7 y Section Put in the Diagram one mark like this I for every Grave in it. And mark this irial with double dagger thus : Designate site of monument thus: Cc] Ble ‘ ,~ PBX, Zo. oq Candles Casket or Coffin No Size Made hy Gloves ' Lining and Pillow Set No a | Bearers or Porters Handles Hearse to ; Plate Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Officiating Clergyman Amount of Bill. » Weal Ck Goods Osdere Bill Charg ep Church Charges Cemetery Charges Music ne teen cena ene iano Flowers 1SSUEO BY DORNTER CASKET CO... BOSTON, Mass. 1010 185 RECORD AND BILL OF ITEMS [1s Tota/ to date Yearly No. Riv the “nae. Residence Place of Deat!: Date of Birth sO 19 Age if, rs/ Date of Death Maiden Name ¢ Pile @ = Name of Father. /“ Birth-place FOR THE UNERAL OF he ph a Bas char Be eee Wife or Widow Occupation His Birth-place WA, herd tas sd thy Years “ f Sex Color or Race Months 4 Single Days Married = > Vrxhewn GAC. Maiden Name of Mother... (hee “WV_aaty xX. Her Birth-place an Cause of Death— Primary‘ | ORR ; = s an oo @ a Certifying Physician ik. diate —t, sa — stipes beso / Funeral Service at _—s Lot No. | Put in the Diagram one mark like this a yk oe ©. og ’ inset ; { for every Grave in it. And mark this Time ef Servios : ere } Burial with double dagger thus : f che BAM cas Date of Interment ) ! 2¢d Section | r Denlenate olin of wninhiiasiaiih tie cl = ye v7: a Casket or Coffin No. I Candies Size . Made by i | Gloves | Lining and Pillow Set No...... | || Bearers or Ee Handles Bion, : Hearse to ~ £ ce, | Plate | Removal ( | | : y, : Outside Box or vant Ay Coaches fF he o < VMe2t Oy — pear | V7 Kaw gine Burial Suit Siippers .. Embalming / Washing and Dressing | Shaving } Services | | | Use of Chairs Church Charges i| 3 Cemetery Charges 0 Music | Flowers || Newspaper Notices Transportation Charges i | Officiating Clergyman Amount of Bill Goods Ordered by Bill ¢ -harged to ‘udioe fea tosis C~| pa Quys Geoaghs, Z bo Fass 7 SH00 DR. Pe CR. oat | oy iy Came To ONT — él -4- y OV WY _ | i - . cc SF,0°E A ane /| oe ee / es oa A Hees ce | | | om os | | cl eer i J 1 Bs a ee | ] | | | ao | | | 7 | —— | | -| a sr 2 | | ——- 1 4 ' |- : | J i eciied siaieidaned a n ia i | | 1 | i | i | 186 Residence Place of Death Date of Birth Date of Death ), 1 Maiden Name Lk e : ine Physicis B f Certifying Physician 74 ¥ Funeral Service at Time of Service / Date of Interment ee Z a } ee i Casket or Coffin No. f / Lao i Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit W o-L2 Slippers Embalming Washing and Dressing | | Place of Burial a \ ba e Tena 1 i Birth-place Foy dh 2 nr LO ; t} Name of Father Lk bak Circe te ih ahr’ C HE Maiden Name of Mother /N@ hha LOW i] Cause of Death— Primary, FOR THE FUNERAL OF : ST Newspaper Notices 4 , | | FI |aQ°e 1 _ RECORD AND BILL OF ITEMS Yearly No. (1G / “ ) 1 Total to date Wife or Wriow of Kobi ee es Years ‘ a Z Months Single / / Days Married YL Occupation AM ens py His Birth-place. 77Y Luge Me (Year) 19 ZO Age (Year) Color or Ra /(OCew Le } o Her Birth-place ¢r Secondary r Residence —— Cemetery / Lot No. Put in the Diagram one mark like this And mark this Burial with double dagger thus : t Grave No | for every Grave in it. Section Designate site of monument thus: fr aw owsed mercy eo Zp») oc Candles Hl T Gloves Bearers or Porters | d Hearse to | f OVOo Removal | Coaches “| H | Shaving Services : ee + Use of Chairs Transportation Charges { Church Charges Officiating Clergyman ee ieee es Bi Cemetery Charges Amount of Bill re, 00 . | % Music Goods Ordered by ‘ | Flowers Bilk Charged to | sina CR. » Tt . I a r b ia C ma Al of || be st ‘ ANS | *VOIOD Rerorxhi\“"B a YX | _t | as Sr" ] A oe a . a | Y a me | | | | | ——— a 198UEO BY CORNTEE CASKET Co » BOSTON, MASS. 10186 187 RECORD AND BILL OF ITEMS FOR THE FUNERAL bal ge a tate # Gi, &v7 sex MaLe_— (Day) (eer) os 19 ZO Age ¢ qG Months 4 Single (Day) (Year) Y Days | Marriec SFO Tota/ to date Yearly No. Residence Place of Death Years Wif "ie idow of 6 Date of Birth Tn or a . Date of Death Maiden Name Birth-place . Occupation 7) roe ctalaanonn CB nos Name of Father east His Birth-place Op AQ LO G_ INO. Maiden Name of Mother ttheg Her Birth-place Co ti Cause of Death Primary Secondary t Certifying Physician € XL: PRL Residence Place of Burial ue Cemetery Funeral Service at 25 Lot No. Put in the Diagram one mark like this ite oC ‘ Doman 'N { for every Grave in it. And mark this lime of Service ee ee Burial with double dagger thus: f imei ate sterme Sectio Date of Interment a Designate site of monument thus: a a : 2 ss Casket or Coffin No. i ni | leo CO.) Candles Gloves | Bearers or Porters || Hearse to (730-20 (dow 2. ZB ay | Removal es Gra. 43._2, Par Vioo Newspaper Notices f St) | (vl /oloo | 7 So Mews 3 le | CO ae Size Made by i | | | Lining and Pillow Set No... } Handles | /2\°0 Plate | i Outside Box or Vault Coaches Burial Suit Slippers 0 xy iEmbalming Washing and Dressing I i | Shaving i] i | F if i} . ‘ | \| Services | | i Use of Chairs Transportation Charges Church Charges | Officiating Cemetery Charges —/ |" "| Amount of Bill Music... | | | Clergyman | | | Goods Ordered by | Bill Charged to Flowers DR. 1 189 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS : Total to date (Be a / i FOR THE FUNERAL OF Total to date : Yearly No. FOR THE FUNERAL OF ck. aes am a a Residence - — CG ¢ ie C a i E wy . ‘Trae Place of Death: 7 { f (s ’ Wife 'o idow of ge Le. Years Sex Color or Ra e Nate of Birth 19 Wis SLO rg // TT + Day) (Year) Months Si (Month) ce Sail 19 Months 4 Single Me oath Day) (Year Residente Place of Death Date of Birth Years sex AL he Color or Race Date of Death Date of Death Maiden Name Days Married (Day) fat gD J\ - x 4 Days | Married Yea lL f @o Ce / Maiden Name - ; Oce upation | / ’ Lb e e, Gi * — 2 i pyee MOND she. ; A CO Birth-place Occupation His Birth-place ~ Cc ¥ His Birth-ol _ Name of Father is Birth-place Ler Che Birth-place fate, A@ _ 4 i ue se ill ia Cause of Death — Primary Secondary oo. eee ie : fies Sa a Corn PI qi Aasuy : ~ Cause of Death-—Primary oridary . : ertifying Physiey ° -sidence “ . : “Pang a2 2p (a Certifying Physician LT GH Kees ) pesidence —_— Place of Burial ir eae ) : anni f Place of Burial oo Cemetery Funeral Service at Lat No : P i i . . . . ; Put in the Diagram one mark like this Funeral Service at Lot No Pus te the Rianne | for every Grave in it. And mark this Burial with double dagger thus : f Birth-place Name of Father Maiden Name of Mother Grave No. | for every Grave in it. And mark this Time of Service 7 Grave No. ate ‘a = iw oO Burial with double dagger thus ate of Interment See 7 . Bi saci ee, ise 2 O Section Section Designate site of monument t! CJ Dat of Inte rme Casket or Coflin No / Tey ——— ee ‘. a = * / oO O Candles Casket or Coffin ie, Candles Time of Service eons Naiinn aeennpeitinatiing Designate site of monument thus: a | Size Made by Gloves Made} Glove fe | Size ade by r . bef ay Lining and Pillow Set No i | Bearers or Porte . > Beare Mace Lae 4) ¥f2 i) Os Qn] _ * Lining and Pillow Set No... carers OY Se Handles | Hearse to 22k, 2a / e) Oo © ee Hearse to Sion Removal fi 3 — [OOo Coaches ieee Newspaper Notices Se leg - s Plate Removal Outside Box or Vault Coaches Ce Burial Suit J / Oo OO ae 4 2CR5 + | | "7.57 Slippers | Newepager Mi Notices Plate Outside Box or Vault Burial Suit » ys lenin bs tailacat Q Slippers j Embalming a IV 0 CO a : | | Wasl As A | Embalming i ashing and Dressing f rE is ea ; fA Dy SG} = Washing and Dressing (Lu biay Ler 2a § K ¢ fe... N=) Shaving AAA ds | Le 7 OO NA+ YA S} | F onaving it | } Services F : I / W "8 Services i] | G 3 3 Use of Chairs Transportation Charges Sti ol Cain | Transportation Charges i | Church Charges ; Officiating Clergyman } / 7 . Church Charges | | Officiating Clergyman Uv Cemetery Charges Amount of Bill | ee 2 Cemetery Charges | Amount of Ril) bee ; : . ; I Music Goods Ordered by | Music i} i op er ee roan | i | Flowers Bill Charged to | ais | | Bill Charged to DR e “n. CR DR . R. a yovanoos TI he al TIXAD _ nn gp pe ~ tg a / £ f A i] + JO Qeorplien et AD ¢) Ly — | O lo} (7 a | | ee : bod | | ek ili = | | | | | ad . 1] p — —_ i ssiiiliiina - ns sve { on ani | | . | | 188UEO BY CORNTER 5 v CO. BOSTON. Mase term 190 4 ~ C~ RECORD AND BILL OF ITEMS Yearly No. \ a THE FUNERAL OF Tote/ to date Residence Neazfo & { LL» | Ree” Place of Death WMecr<y/ Wife or Widgw pf 19 f Sa Years Sex 7 Color or Race Date of Birth Moath Dayy Year Date of Death Rechte } ... 19%O Age Months Single a Maiden Name . Y t , oF Days | Married { Birth-place b5hiwtii_ae/ init Name of Father ty His Birth-place > Maiden Name of Mother Her Birth-place od Cause of Death Primary Secondary a Certifying Physician B/W Residence _— Place of Burial Cemetery Funeral Service at Lot No. Put in the Diagram one mack like this Grave No. | for every Grave in it. And mark this Burial with double dagger thus Date of Interment 4 Lr4r2g 9 Vo ° Section Time of Service Designate site of monument thus: [ ] oss lsceesensesrssonaiam TE ea eee ee | | ng = epee Casket or Coffin No t 2 f3 Oo | Candles ! . ; i! Size Made by Gloves i = s i Lining and Pillow Set No Bearers or Porters i ag i a a Handles | Hearse to New 24k —_ < JOo i : Plate Removal i Outside Box or Vault Coaches : Burial Suit Slippers Newspaper Notices | Embalming | | Washing and Dressing Shaving Services ' r Use of Chairs Transportation Charges Church ( harges Officiating Cle srgyman. | toe Cemetery Charges Amount of Bill | : ‘ i | |— ee eeeenn Music Goods Ordered by es pent | ( r Flowers Bill Charged to Ty pes | Qenf DR. . A ; a I el wes Ae | _| NO Reeck Of beer ope P| f = } | ‘ I i] | - 7 | a | | - | etc : Lease bla | s@UEO By i ye cc sah tei», wy Pb Naga. i" — Vipers, j yh, PP he a a3 Fa rg ae RECORD AND BILL OF ITEMS [27 Yearly No. FQR THR FUNERAL OF My b (hiry Ka yual Residence Place of Deat! , a = Maiden Name a aD Birth-place GB wf fe Name of Father Fev 2 Maiden Name of Mother. (2t<e~ £ te Cause of Death—-P ~s Certifying Physician WW PWN eae Place of Burial Bec Funeral Service at ee Time of Service Bice . Sire Is Oo Date of Interment room oe Yo Casket or Coffin No. — J VI O° Candles I Size Made by Lining and Pillow Set No..... Handles Plate Outside Box or Vault Burial Suit Slippers "s | al Embalming Washing and Dressi | ) | fle hors 7 Shaving | Services he bf Chairs [..... Doubts cod re I\ a if] \ Church Gbarges oe i : \ . Pe, ld AA tl rod Cemetery Charges j ‘ft @ ti ‘ 1 Music ea, | I tr lowers Total to date... / ? S. AL. Wife or Widow of ¢ ] ff Date of Birth soi x ¢ ¥y f 4 7 Y Years ing I Color or Race (Month (Day) (Year) Date of Death d x, 19x Age ie ra uth 4) (Year) a | / 2 Dave od Occupation His Birth-place Ly Her Birth-place “hg Secondary Residence ez g net Cemetery kRov/ Ca Le To— Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this ! Grave No. Burial with double dagger thus : ¢ | . 2 Section Designate site of monument thus: C) Gloves IF JAG Hearse to Remo¥ahe.. ee ; ( ‘oaches Newspaper Notices | Bearers or Ports | kp. | oe a DML | | | Transportation Charges 4 alt Officiating Clergyman 4 . A i Amount of Bill 4 < 7 a + ‘ ni 7 Goods Ordered by a f co ie Bill Charged to md ka wd ME Nile Pil; 2} } || ~ ly i pier a i < | | i | } | i - | | | | | eee | j i} } | i —| | | | | | + \-— | IE ee “H | } ines Se et eee ; = leat ‘ae ee ii a a | scenic litical ee | | | T | ISSUED BY DORNTEE CASKET CO. BOSTON, MASS., 1010 RECORD AND BILL OF ITEMS Residence Place of Death Date of Birth ter Date of Death ; Maiden Name Birth- place Name of Father 3 O_ Maiden Name of Mother one Cause of Death P —s. Certifying Physician o Place of Burial Funeral Service at Time of Service Date of Interment C16 cb ha Ca Q 617 FOR THE FUNERAL OF ‘ whether € Or iow of mat cupation Sr His Birth-place Her Birth-place a Secondary Residence os g semetery 19 ! g Years Sex (Year) Mone 7 Months ¢ Single ffr4 Days Married men Lot No. Grave No. Section 2 Tota/ to date .. Color or Race o , stata a r~e! “e- _ oo ie Put in the Diagram one mark like this I for every Grave in it. And mark this Burial with double dagger thus : 1 Designate site of monument thus: i Casket or Cofin No. / Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers 3 a OO. Candles Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Le fu Bill Charged to : es | | 1S8UEO BY CORNTEE CASKET CO. BOSTON. MASS. 1918 RECORD AND BILL OF ITEMS Yearly No. Residence Place of Deat!i Date of Birth Date of Death . » Maiden Name Birth-place (Month) Name of Father Cause of Death ie Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment jp Casket or Coffin No. vile. Size o Made by Lining and Pillow Set No...... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers w 1972 Arges 7 - Cz —— Occupation Maiden Name of Mother "A Hep fo od i a toe FOR THE FUNERAL OF 193 426 Tota/ to date A® (Beausus Kote) Wife or Widow of s Years Sex Months af Days Single (Day) Year) 4 Married igor Birth-place Her Birth-place ee. Secondary sidence Ma Le lbrkhike— GBreecec @ AO. Lot No. Grave No. Section | 7S On) Candles — Gloves Bearers or Podlers Hearse to4 Removal Coaches Newspaper Notices Transportation Charges | Officiating Clergyman Amount of Bill 4a Goods Ordered #€ Bill Charged to Pci flr fbue MEK KF, Color or Race Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate site of monument thus: CI | | | | L | 1SBUEO BY OCORNTEE CASKET CO. BOSTON, MAGS.. 1016 et ee ee salaeaenneninernermreemeee nee RTI DE ene Residence Place of Death aan Date of Birth Meo / ° Date of Death " yy oath es Maiden Name Birth-place Name of Father” Maiden Name of Mother Cause of Death— Prim Certifying Physician Place of Burial Sova Funeral Service at Time of Service fs 24 ; “oO Date of Interment eceeemeccemeapeomeenente qa Casket or Coffin No. . Section Occupation His Birth-place Birth-place — mdary sidence vemetery Lot No Grave No. Candles ie ? RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date Wife or Widow of BOF 57 Years Sex “pate. Color or Race se Ags Months 4 Single ‘ + /G days | Married fLY te to Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus Designate site of monument th: a oan | | | } \\ { 1S8UGO BY DORNTER CASKET CO BOSTON, Mase... tOTe Size Made by | Gloves | } i Lining and Pillow Set No Bearers or Po . | 4 Handles Hearse toZ (CLL DELL i {2 PO Plate Removal - | 7 | i Outside Box or Vault | Coaches f | Burial Suit a | | Slippers | Newspaper Notices i} | | Embalming | \| Washing and Dressing | } Shaving | Serv i1<es | | + Use of Chairs Transportation Charges Church Charges Officiating Clergyman c . ‘ Fa gs Cemetery Charges Amount of Bill oi , | iB Music Goods Ordered welled a ¥7 = | Flowers Bill Charged to & fs c LY = i —- 2g DR. q CR | | ogee bree _| | | ] | } i | | | i} 2 | “| 7 —— = | | i} | —] oe | } \\ | i } {| yo } 4 | | = ] \ | | | i | . | | | i} 195 RECORD AND BILL OF ITEMS ne; Tota/ to date Yearly No. Ae. (dai FUNERAL OF Residence | i a A Place of Death sme 7 or Widow of a ‘ Date of Birth yf dase oo Sex Make Color or rp fk” th} (Year) Date of Death peel Single onth) ‘ 19} O Age Catt ye 2 N a C . Jecupation Maiden Name oe Days | Married His Birth-place Birth-place Name of Father 4 oe . 7 a — » r& Maiden Name of Mother y s Bb Her Birth-place Cause of Death—Primary Secondary Chk-4-02_ 2 2- Certifying Physician Residence _ f > Place of Burial oe. ee as C, Cemetery Funeral Service at Lot No. | Putin the Diagram one mark like this ; ’ ; : G d k this Time of Service Grave No. \ i for eve ry rave is we Anc mar as / qG 20 4 Burial with double dagger thus: f Date of Interment Section : Designate site of monument thus: | ees Casket or Coffin No. Candles Size Made by Gloves Lining and Pillow Set No.. Bearers or Porters Handles Hearse to | Plate | Removal 1 Outside Box or Vault Coaches I j Burial Suit New spaper Notices Slippers ee Embalming Ro en mea Se eH ey ( Al Washing and Dressing Ann i: | O' } | Shaving | ] 1 Services | } | | Use of Chairs = ransportation Charges } Church Charges i Officiating Clergyman oS ae Amount of Bill E Cemetery Charges Goods Ordered b \ Music | \ Flowers Bill Charge DR. . CR iu 2 ateidasl “pan a lap © Ain tel | pe 20 fel, tpe lle, Ka GE. 1 | - i f | _ — —_ i | J <1 ——4j——£ } | | 4 | | = ee | | | Ea | | | | \ i “| | | 1} i oh ci eeteheemmiai - } | _ H \ j } i\ i | 4 l | : es i : | l ‘ Se = oo ae ! i j_|—_j__|__4 4 } li } \ i | 1eeURO GY OORNTEE CASKET CO., SOSTON, MABB., 1008 dale ~ Pg 1) 196 ? 5 197 | RECORD AND BILL OF ITEMS s pe RECORD AND BILL OF ITEMS a | Yearly No. / 77 / FOR THE FUNERAL, OF Tota/ to da Tota/ to date i | AYP - Me, e ( Tain, Cepere ' Malton 1 Residence = . Residence Ly Que f-- LK ofr f me : ‘ife or Widow of ¥-@_2.¢ 2. 93 Wife or Widow of Maree , Place of Deat & Place of Death , . 7€ —— df o Date of Birth pul, { 9g vO 2 Le ate of Birth ree oe ] peo Years io es Color or Race Date of Birth P WV - igf g 19 ts ) (Month) (Day) (Year) y > ) ¢? 3 . Date of Death Months ps Date of Death \ / k 19 2 Age Yearly No FOR THE FUNERAL OF z Years Sex “Atala P Color or Race Sf Months Married Maiden Name Single few ‘ Vebese Co Pel 77 daw lean (bktte— es a _ oe f ¢ Birth-place LL 2” we Oecupation ss eh chaa Rea of 2. es 2 @ His bite GAs, a CA tae QLbott-Creggree bfalfo.s,, Dittailace BK hemo @G@ nC Her Birth-place Lk, : ate Maiden Name of nisiner thas, yee. hu htovArer Birth-place 3 is a Cause of Death— Primary, a Secondary : { x — - ne / © Cause of Death—-Primary Secondary : i Certifying Physician Claas Residence ie viii . DY F Sf ° C2l J : @ elev : aL . : Certifying I eg: ce @ i: © wane en ‘ _f O28 aa ™ 7. Fiace of Buriat ne = j-emetery ; Place of Burial | Bw Ror. co he vemetery / “ ; one rae Ch B / Funeral Service at / Lot No. Put in the Diagram one mark like this Funeral Service at (CL__-Ch/ Lot No. Put in the Diagram one mark like this ie : “ . ar Time of Service Grave No. : I for every Grave in it. And mark this 1p: = . | oO ; a 0 : srave N | | for every Grave in it. And mark this ~, ‘ , oO. 0 Burial with double dagger thus: : Time of Service ( 3 /c 2 j Burial with double dagger thus: ¢ q 20 Section Date of Interment ‘ / 2.0 Section i S : " Destenata ad e Date of Inte rment ; ‘ | : gnate site of monument thus: [ ] J | . : : f } | | | £ / ] f Designate site of nonument thus: mal (Month) (Day) (Ye (Mont) Year Maiden Name - Days 4 Birth-place --Qen— oe Occupation } Name of Father MAS : Maiden Name of Mother i ; ¥ 73, 5 | on i " — a = a ea 7 f Casket or Coffin No. doe BIG, / J ©.Q.| Candles i | Casket or Coffin No. ¢ 4 a] N Candles | | . \| | | i} H Size Made by Gloves | Size Made by J | | Glove S | | Kdning and Pillow Set No. i | Bearers or Porters | Lining and Pillow Set No.. | :. $5 Bearers or Py, I~ ‘ . é Handles Hearse to | esting aoe SS A g oO a H®rrse_to ca the A ne _ i Plate | Removal ] Plate : Removal ig | Outside Box or Vault Coaches Outside Box or Vault Coaches Burial Suit Burial Suit i ] Slippers | Newspaper Notices iH Slippers | Newspaper Notices . . | | Embalming | Embalming | Washing and Dressing Washing and Dressing I Shaving | Shaving .. | | | i Biase) j Dervices } i Services | | | i Use of Chairs | Transportation Charges Use of Chairs i | | Transportation Charges ; Church Charges } Officiating Clergyman i ; Church Charges | | | Officiating Clergyman | j | | “ Cemetery Charges \| Amount of Bill . Cemetery Charges | Amount of Bill 7 hf - Atie-o i Music Goods Ordered wh ALLEY Music........ | Goods Ordered bX * » Jas 2% Og a | : a Flowers Bill Charged to ft A Flowers | Bill Charged to i DR. CR DR c ie . 7 R. ; , i ; b ~ ‘ é | oe iO O ji ieee } 1] ai \ O Geren a 'O6 CLkATS Bak FH? (9; 7 >i [O00 | } ~-|—— camecaenbianianids | | —, iceman . | | _ . a ee ) | ee | | ee | | | To. | jer > | ae | | ao ey ae i te 7 PRXS. pa : 2 | i | | — { , a f i Py | H | | | = ~~ \ a _ aa a oa | —| ~~ | | : {| ail ; , | oe | | Yegoe A, ST | | | | | | AMT 5 / pe | | a | | ] YI, / Tao lve } | | | | / A , a ws 7 . Peay. Garfnh | | | } | : - + | - | —_ - a i . | | | | i | - | | a | 2 —_ 1 | " | : ——— | . | ae | Wl I od —|— i} i | | | al . a ce scales cade ; I ] | | | | | od od : | | 1 e Poe | ’ q “i | i I ‘al . i ibaa i asc enene ana j } } j | a Rey | | {| | | i] } — : | 7 } | | | —“y saci roselare aii ileal ini sae es aa as Hh scseronemmnsinisrnel sities a - : rt | } | , - | i ‘= | | | | | | e | . ISSUED BY DORNTEE CASKET CO, BOSTON, MASS. 1018 188UEO BY DOANTER CASKET CO. BOSTON. MAgS., 198 RECORD AND BILL OF ITEMS Yearly No. (3/ FOR THE FUNERAL OF i) Ov mace/ rile “I WA Wife sae of f 7. Years Sex Tota/ to date Residence Place of Death Date of Birth 19 ‘olor or Race ate O sii ae ee Color or Race Date of Death 19 Age Months 4 Single (Month) (Day) (Year) Maiden Name Days Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician Residence Place of Burial Cemetery . al Service at : . Funeral Service Lot No. Put in the Diagram one mark like t! | for every Grave in it. And mark ¢/ Grave No. Burial with double dagger thus : Time of Service Date of Interment Section Designate site of monument thus: [ ] | Casket or Cofhn No. Candles Size Made by | Gloves Lining and Pillow Set No. Bearers ey Porters Hearse wAQ2oge Removal 1d saben a4. 2 ! | - oO O° Notices Handles Plate Outside Box or Vault Burial Suit Slippers Newspaper Embalming Washing and Dressing Shaving 6 Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill | as Music | Goods Ordered by ba Cay Nirethss / Flowers Bill Charged to fs Y Cathaniisa— DR. ‘ i oe cei | | | aE es ooo | | | | | | | ‘ ‘ i i {- | | | | | i apoied | | | si | | | | | i a — | 4— | +|——_--——-—} ees an 2. ss res oe co erences mn 1SBUEO BY OCORNTEER CASKET CO. BOSTON, MASS. 1018 ~* RECORD AND BILL OF ITEMS Tha hake odfind (eck ) Yearly No. Residence Place of Desai! Wife or Widow of 199 Total to date. | ¥ of. Date of Birth 19 E Years Sex Color or Race (Month) (Day) (Year) Date of Death 19 Age Months 4 Single (Month) (Dey) (Year) Maiden Name Days Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother. Her Birth-place Cause of Death — Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this Th ain ait Gai an Cue Na 1 | for every Grave in it. And mark this n ae sy } Burial with double dagger thus : ¢ Date of Interment Secti | ‘ ot ate | [ Designate site of monument thus: CI nani Casket or Coffin No. Candles | Size Made by Gloves Lining and l’illow Set No.. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving “services Bearers or Porte @ lece_ Hearse to Removal” 2 Ke ov res ol Coaches Newspaper Notices 2¢ lorvce ea, / Kg Sah / | PIOO Use of Chairs | | Transportation Charges Church Charges Officiating Clergyman Cemetery Charges | | Amount of Bill ) /d, Music | | Goods Ordered by 4 x ad | Flowers Bill Charged to DR. wee fail fo ‘ CR. re RT MT faa eS i ISSUED BY DORNTEE CASKET CO. BOSTON, MASS... 1010 201 | : | RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS 3S Yearly No _FOR)THE FIUNERAL OF Tota/ to date Yearly No. nein te nim. OF Total to date A: — : fhe. Residence likin Lhe a Cc” 1 ace of Death Wi ‘idow ; Place o - ’ ; g ¥'é W — of : Eg Dine dl Thasih os ic i iis alt : t Date of Birth are Years Sex : Color or Race Nate of Birth 19 © Years he <é mke Colos or Race alll | ene ge 7 ae _ a ri Peter 0. iia Date of Death ey) g” 19°20 Age Months 4 Single SEQ, ear) “ - ‘ > s ase Maiden Name ae. Days er ~ (Yoarkg, oe @® ne’ Maiden Name ; s Days | Married Be oe oe 0 Owe } Birth-place ¢ Jecupation Co. Birth-place et— fAtc_ace— Occupation } Mame of Father Micclt. Birth-plac Name of Father . ik His Birth-place Maiden Name of Moth Me hba ise, Birth-place Maiden Name of Mother os - Her Birth-place Cause of Death Primary Secondary 2 vs Cause of Death— Primary Secondary Certifying Physician oe ee Ae __ Certifying Physician Kh f NH (Oe eran Resilience ae ee C ye 4 _ Fs nt Place of Burial CaQe 1d Coenen Cemetery , O/ Wo Qaee elms A. e_ k aA ee . J f accel eet (Pow nae Put in the Diagram one mark like thi Funeral Service at e Pw Lot No. | Put in the Diagram one mark like this ! Piven nf Sacvion ‘ J Seon | for every Grave in it. And mark this ae ‘ : | Foca sana Swave in it, Ane & this re ae L i a Gaave No. Burial with double dagger thus : t lime of Service : = O Grave No. J ee aie uae on t Date of Interment y 7 Section Designate site of monument thus: Date of Interment / 4 - Section ; i / f ] Po g ] [ Designate site of monument thus: Cc ; : ; ae ~ oo - ae Cala oat a a T 7. : sacar netomat i j Casket or Coffin No. ~PLBASD 7-9.|| Candles Casket or Coffin No. t TI)OO Candles | i t | i| ' / Size Made by Gloves i} Bice Made by Gloves H | i} si } Lining and Pillow Set No Bearers or _— } Lining and Pillow Set No.. | Beacons gar Picken 2 Handles Hearse to .. _ Urea } ‘VT O° Handles | Hearse to a oe Plate | Removal v Plate Removal Lo i 2 Outside Box or Vault Coaches Outside Box or Vault Coaches j Ca ef “ae 9 So raed Burial Suit Burial Suit 2d ; . | A Ets ef o¢ Soe-Ye ‘ 2 ‘ : Slippers | Newspaper Notices | Slippers | Newspaper Kori a : 2. A €e waht. Jlioo Pees | | | Embalming Embalming | ‘ Loam Washing and Dressing poe tees | ‘ L if - | ng ing Washing and Dressing | ~~ 2 lt “ee | y : A. i ; Shaving Shaving .. | | Cn, OQ A tay i a | @ | ' i Services Services | | “te } j 4 | | i | ; Use of Chairs Transportation Charges { Use of Chairs lransportation Charges | | Church Charges Officiating Clergyman | el ee Church Charges Ofheiating Clergyman ua at | Cemetery Charges Amount of Bill ee, c __JJ5\20 Cemetery Charges | Amount of Bill Z | JF Co yg i f i! | 2. V4 . | 4 a Music } Goods Ordered by» Uk | Music i| Goods Ordered hy 7 Xe Elenen | ; a : ‘ | | j 4 Flowers Bill Charged -:.. : 7o Flowers Bill Che irge sd to L} Cte a k is ai qussnahnemseeuet . . | i ag sreinit atesinee DR. DR. f ad sae é 4 mnnnneseioghuens nat} 4 wo t i | fee : Te es (a Ganon | i Ei VI Cer Klee | KM lo” 24 is ot O Meret Gere | Offeo ay [4 [2O\WLp U tk Ge] Was 4 | Eile | | = | i ie |" | _ | 4 = | | | | | | | —_ | _ — — “Tl | ¢ I t Pe ee : | | | | _ , " } | | 4 | / |. i | | | | | | | e | —| i| I | | 1 | “ { | | a es ~ i- _ ial | — | | | i icineebieaalil a | a | | — “ | zs es | i} ——— - 7 | | | | } | | | 1] Hy j i} | sabi - - |—- — -| } —| ae ss sie lee pene | > i 4|— es | os oe | oa | —— | | | | ad = | | H ISSUED BY DORNTER CASKET CO. BORTON, MaGe.. tere ISSUED BY CORNTEE CASKET CO. BOSTON, Mass. 1016 202 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS - _ THE FUNERAL OF Total to date s/o Re egg A iy een nv =f LL 2 “e- (2 Apr © . , / aa vQe, “ALS ‘ife or Widow of ‘Ceo! ce CMMs ta Place of Death Wife or Widow of Diace of Deail as : Wif | / Hie 22_ Date of Birth LV 7 Years Sex Color or Raée Date of Birth Sc ¢ ¥sb 3 Y Years sex ese d 22 Color or foe, " ( poh (Year) — ; (Year) Date of Death 19 26 Age [oO Months 4 Single Cpe Date of Death ; 19 ZO Age a Months 4 Single wer) ’ Eh t KDay) 4 ney Paap / ar om FOR THE FUNERAL OF Tota/ to date Yearly No. (Year) Maiden Name : / a Days Married . Matton Name AL2 oS Macvied Birth-place ; ‘ ‘ : Occupation A Birth-place 2 al 7 me Name of Father His Pirth-place Ree 2 AG . Name of Father (ages His Birth-place wey AL, r fother : ee Her Birth-place CO Laden ; é Secondary Cause of Death—-Primary Secondary Cause of Death -. We, Certifying Physician = : ee SFT les veda AL Certifying Physiciz Res gf ER é » certifying Physician tow 8 [ e “Ke _ wed metery Place of Burial €9—e2_2>—f Ceme Place of Burial Funeral Service at Pcneliey Te naa Aonaes ; oe metho ous OL ol- No Maiden Name of Mother r Birth-place £2 “ Maiden Name of Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: f Designate site of monument thus: C) Put in the Diagram one mark like t! Funeral Service at | for every Grave in it. And mark thi Grave No. Time of Service Time of Service 5 . Grave No. j spi Burial with double dagger thus : 7 i 5ecti Date of Interment us Casket or Coffin No. F~ /La sO .| Candles : Casket or Coffin No. / ¥ 0.0 O Candles rennin atcenontebiints ! 4 rv O Section Date of Interment 4¢ . Section ' ; ; Designate site of monument thus: [ ] Gloves Size Made by Gloves \ : Size Made bv Lining and Pillow Set No Bearers or Ports } Lining and Pillow Set No.. Bearers or Porters Handles Hearse to ! i Handles Hearse to Removal Plate Removal ne eee Plate Outside Box or Vault Coaches / faze (ilesainity / | Outside Box or Vault oc / | Coaches Burial Suit Burial Suit Slippers — Notices Embalming . A fax me 7 2 | Embalming AAT (J e = } Washing and Dressing UY, Te daf--00..<8 Washing and Dressing & Z h S437 ¥ 8 é B Shaving | ohn bo -Lse™ ; et Pres A , Shaving Dervices —f- eh W | ae { f . | a Services | cs 7 Transportation Charges. | : \ a } : Use of Chairs | ) te jan tation Charges Church Charges Officiating Clergyman aes i i i Church Charges Ww f q O O} Officiating Clergyman | Cemetery Charges Geroefer = Amount of Bill g- ee Mis. sal i Cemetery Charges i| Amount of Bill ff « Music Goods Ordered by — | | Music ] Goods Ordered by, Su, (7 pS — Flowers Bill Charged to Ao| } ae Flowers Bill Charged to i : e . a ommenenm veenatinl cami VU ¢ DP DR CR. Slippers Newspapet Notices Use of Chairs DR. | Jo Cer k ade. [bea fiefs De Che eh | yO o2 (ay a teem irae BUF 219 oo } { | a | ’ | | | a | | | | | j i | | c. ISSUED BY DORNTEE CASKET CO. BOSTON, MASS... 1010 | 14 | 1SSUEO BY DORNTEE CASKET CO, BOSTON. MASS. 1016 204 RECORD AND BILL OF ITEMS Yearly No. / 5 OF / Mrs. oF tie Ca, Se og 2. Residence Place of Death Date of Birth Meg 3 ‘ie GGL B pe Age ; a FOR THE FUNERAL OF Tota/ to date. Wife or Widow of Ke tte ar. 3 Years Sex Gira W OL Color or Race MAC Date of Death f 0 Months 4 Single / (Moan / f 4 Maiden Name. / 44 A Ot At tL Let As Days Married Birth-place me Ct b Ey Occupation Ct A ‘ fe Name of Father / : : s Wy e SA Maiden Name of ZA zw Up ec Cause of Death— Primary Certifying Physician Cae tA“. tg i A Place of Burial Funeral Service at Time of Service / Date of Interment sponacng te Casket or Coffin No. Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. Lh. WM J Athlone f MM pty J MC eee A > Lich Lf o Ce 0 a 42 he His Birth-place Her Birth-place Secondary ace: ( 3 /, t Residence >+ ie Lely ae A LAAN 8 Cemetery Lot No. | Put in the Diagram one mark like this a 4 Coagn Bin: I for every Grave in it. And mark this ¢ Burial with double dagger thus : ¢ Designate site of monument thus: Cc] fk FEA section | O-C| ¢ \ Ai AS Candles Gloves | Bearers or Porters es ~~, s G7 oe U v Hearse to y a pk Removal! Coaches Newspaper Notices el ee, I So Transportation Charges | 20L66- Os Cure / as | Amount of Bill | Goods Ordered by [huey ~ fal A 0 01 0C | oluf __| | Bill Charged to KV. tad = see i? MM Officiating Clergyman ae 20\2 Chirk phil 7 f CU Oh ISSUES BY DORNTEER CASKET CO, BOSTON, MASS. 1016 75 | CG Yearly No. f Ae . 4 it/ a. We a i f aie ee A Residence Place of Deat!i Date of Birth 205 RECORD AND BILL OF ITEMS oe V : FOR THE FUNERAL OF Total to date. tl « 118 OK Wife or Widow of Ik i. oe sex (MAM Cage te i‘ fre Date of Death V < ak 7 a. ¥.. 1940. Age Months 4 Single . Maiden Name / | J Days Married + ¢4 4] Birth-place Vw ve m3 LA Occupation V4 c sto aA : i Name of Father W. tas AL lA- io His Birth-place ad: £4 ae | Maiden Name of Mother... c tt2918H. We x ¢ Her Birth-place fs Sto Cause of Death—Prim ry : Secondary Se : Certifying Physician ll, JU ‘ AT: (Ll az.+4 Residence ~~ Ca ced atte Place of Burial fA tt ge Cemetery Funeral Service at t 4 é ae ks & “4 Lot No. Put in the Diagram one mark like this Time of Senice BO / (0 Grave No ene ee Date of Interment Lf tt “y 7 Section | : r Casheneiedeeetaudinnniies co Casket or Coffin No. er re ¢ Candles Size Made by | Gloves Lining and Pillow Set No... | || Bearers or Porters on Handles : | Hearse to C eel vid ‘ ot Plate | | Removal : ~ ? ; | fos / Cc af és Le 2 @asd Outside Box or Yanlt i Coaches oe - a we CP of i Burial Suit /| tA | LL “lec | yA — Slippers Newspaper Noticg : , Embalming | p-- | Washing and Dressing | 7 fRawtK . Oo Shaving .. | | Services | | | lod Use of Chairs Church Charges Cemetery Charges Music.. Flowers Transportation Charges Officiating Clergyman } | | Amount of Bill : | | oy 0 Goods Ordered by L144 CF eer 18 ; Cat oe Natl Bill Charged to Cr. vi eI en 19GUEG BY DORNTER CASKET CO.. BOSTON, MARS... 1016 206 RECORD AND BILL OF ITEMS Yearly No. /S q. FOR THE FUNERAL OF Tota/ to date We | tH. Vaasa _ Residence ee : & sae Place of Death \ life or Widow of | Date of Birth ie Years Sex MeLe Color or Rac: Date of Death YO Age Months i : r (Year) Maiden Name Days Birth-place 7 His Birth-place Name of Father Maiden Name of Mother Her Birth-place Secondary Residence Ghat 2 Oe wa ‘C— Cause of Death— Primary Certifying Physician . o. t Place of Burial far 04 ——_-- Cemetery Funeral Service at J ( al ice a Lot No. : . | ‘ Put in the Diagram one mark like this Time of Service Grave No. I for every Grave in it. And mark chis Burial with double dagger thus Jate of Interment Section Designate site of monument thus: 7 gi Casket or Coffin No. {Co © © Candles | Size Made by | Gloves | Lining and Pillow Set No. | Dectabs nv Dacian a i Handles | Hearse to Lkakisr | See Plate | Removal | Outside Box or Vault Coach « ~ | Burial Suit Mug png | sf Co Slippers Newspaper Notices Embalming oe Qo | Washing and Dressing é y : Shaving Services $$$ —$______4 Use of Chairs Transportation Charges Church Charges Officiating Clergyman jeiliniiaiabaaiad ees Amount of Bill Music Goods Ordered by th po pA LG - Flowers Bill Charged to VG Cemetery Charges 3 : _ a L ‘ | dae n@ertey \7 17 a x.)) Mi tictielinininansiniionel | ISSVUEO BY CORNTER CASKET CO, BOSTON. Mass. 1018 207 RECORD AND BILL OF ITEMS / O Tota/ to date Yearly No. FOR THE FUNERAL OF Wea. - sank ©, Ae Ae Residence Pras... +o. Wife or Widow of AK — 7 6A Years hee yf a (Day) ar | Ly 198 : 6 Months re P 4 pr . / . eT, io ct, c of Occupation . fe WW. Crtk tar His Birth-place ee &. Name of Father Maiden Name offMother it Madd Her Birth-place Cause of Death— Primary ; Secondary Certifying wt Caacron ‘ “ : Residence Place of Death Date of Birth Color or Race Date of Death Maiden Name Birth-place aie ae Ceres ' Cemetery Lot No. Put in the Diagram one mark like this Ad Cua Ss 1 for every Grave in it. And mark this Time of Service ee Burial with double dagger thus : ¢ 7 eee ] Date of Interment “fol Section \n._5 0 od Candles Gloves Place of Burial Funeral Service - Designate site of monument thus: Cc) Casket or Coffin No. Size rs Made by Bearers or Porters Lining and Pillow Set No... | || Hearse to etn Zod Handles . Plate | Removal Outside Box or Vault | ome | Coaghes Dye <o | 5 Slog AfO-<aL e 14-7 Burial Suit A/S -¥ S77 | Slippers | PX. Notiges | Ago Embalming i 4 one agg | welt sai d | | +y- LA 1 Aa j \ : a . 4 ‘> » 7 | ; | | | Washing and Dressing iV s Q Shaving a - -— Services OO Transportation Charges | Officiating Clergyman Amount of Bill | | Goods Ordered by fell Vick | Bill Charged Wu LB. Uwrha lo | Use of Chairs Church Charges BZ FO Cemetery Charges Music............ Flowers DR. CR. wp aur ee, | ey te Bs, GA—_] 30 sso. | ae 6h SOE BE | | | PS oe . | — ee | —| | “ | i|- — ! | Ree H | | | | oo | a | | , | | . = i 7 | ede = = cue io. me ee Seal He a Deel Se Sp arcana ater 6 SERRE ITA 208 Yearly No. / ¥ [ Cot opi RECORD Net; eT Weta. rs SHOR Lo vhh, Place of Death HE FUNERAL OF Oe ~ Wife or Widow of Sex MBL, ND BILL OF ITEMS Tota/ to date Date of Birth 19 Years : : ; eon Mey ae Poe Color or Race ate of Deat { : : ; ate eath econ se 19.3¢.9 Age Months 4 Single “7. 2-9 bd Cue + Maiden Name / 2) Jo (7 Days Married : J TC / 7 (/ os : Birth-place ‘ ch £22 Co) Occupation Name of F ver His Birth-place ‘ Maiden Name of Mother : Jer B : irth- pice € . ; : re: ta ths: ie OD fie eo Cause of Death Primary ne Ulery #9 a. $$$ Certifying ee fs = aaa Residence ( Ss s Place of Burial RE LRA <s L J Cemetery f, : ‘ Funeral Service at a4 Pn Lot No. Put in the Di e utin the Diagram one mark like this Time of Service - Q. Aad Grave No. I for every Grave in it. And mark this Buriz e dagger thu Date of Interment _, fia wy 2 Section Rae eaala € aa Designate site of monument thus: Cc] ee SS so. -_ ¥ Casket or Coffin No 7722 Candles - Size Made hy Gloves | Lining and Pillow Set No | Bearers or Porters Hand) | i } y andles Hearse to 1206 | i er Plate Removal bat Paes. , | VvO°O | Outside Box or Vault Coaches / i, Burial Suit © je oO Slippers _ Newspaper Notices Embalming ? o |Q 0 | ; I Washing and Dressing L0ttrae. © errt /\yJ Shaving ! t Co ee 5 © Services oa Use of Chairs Church Charges Cemetery Charges Transportation Charges | Officiating Clergyman Amount of Bill Music Goods Ordered by C Au, 4 Flowers Bill ( tharged we t Oe Chere Da ( DR. is : Vo ark (ee rt | | Be | |_| J | <a i | | a“ | } “+ -| 4 1SSVEO BY DORNTER CASKET CO. BOSTON, MASS. tote . RECORD AND BILL OF ITEMS Yearly No. a (Boas L Residence c Place of Death Date of Birth Date of Death “) (Mgpth) ) Monat) ay) / Maiden Name Birth-place Name of Father P Maiden Name of Mother A Cause of Death Certifying Physician e.. Place of Burial Funeral Service at ; Cy Time of Service OL cc Date of Interment 2 Primary - (aS Made by Casket or Coffin No. Size Lining and Pillow Set No... Handles Plate Outside Box or Vault ns Burial Suit V. Naso Slippers Embalming Washing and Dressing Shaving . Services Use of Chairs Church Charges Cemetery Charges Music.. Fl »wers DR. Cru Genz crrnosr— Lupo Qkhtoairhkt. Ae oy ce eee c 209 Tota/ to date / ce FOR THE FUNERAL OF I Be Wife or/Widow of ‘ 19 | z Years J Sex JA eke. Wen. 19° FH Ave Months 4 Single (Year) f Days | Married Ov <1 1 iS ~ ccw on. ar i Birth-place | ah Da a Ate aee./Ce AC. Her Birth-place ADL Secondary Z ; Residence ee iretery Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this Grave No. Burial with double dagger thus : $ Section , -— Designate site of monument thus: te , BM i 2 ae 7kIVQ Candles Gloves | | Bearers or Porters | Hearse to Removal em | | | aches | Slt | A de | Newspaper Notices Transportation Charges | | Officiating Clergyman | Amount of Bill en / 7. Eve olin n2/ F re hf - j ,00ds dered by — FHS: ae ea Bill SP to | Prrctcnlios Of,” | caps anata agpeUIE ana eeenaR Tatarstan i Rat BOR pe cn A 210 r RECORD AND BILL OF ITEMS Yearly No. / ¥ ve s . ) Tota/ to date he aston, hry cose) Phan occ Ove fuse. wy ) Months 4 Single Month (Day) (Year) wr or ke ¢ | . —-. 19 FO Age 7 (Mon (Toss) ¢ > / mye ied a Birth-place 3 Ay Lee g i Rab en Name of Father 4 itA v e Che ‘ Maiden Name of Mother WW Her Birth-place Cause of Death Se Pope FOR THE FUNERAL OF Residence IE Place of Death — ste — Wife or /idow Date of Birth Qeoey [KTLac/—~ 19 me Years Sex Wako ae Date of Death Maiden Name Occupation His Birth-pla Primary Se od Certifying Physician Vauth rea Place of Burial <@g “3 Funeral Service at J Lot No. ; Lek p ¢g : Put in the Diagram one mark like this ia at Carvin 4 —< | ro Gre No. | for every Grave in it. And mark this —f ie: Burial with double dagger thu Date of Interment <.. { } ‘i aa Section r Designate site of monument thu L ] seinen iinet : ’ Casket or Coffin No. . £ . V wo ‘eal Vo ea Candles Size Made by i| | Gloves | | | | | |] Lining and Pillow Set No. | Bearers or Porters I mn i| | i Handles Hearse to I I Plate | Removal i Outside Box or Vault Coaches | | | Burial Suit i| Slippers Newspaper Notices I Embalming | | , ° | | Washing and Dressing | | Shaving | Services | ]. ff x 7, Use of Chairs Transportation Charges | Church Charges ' Officiating Clergyman salad Cemetery Charges Amount of Bill / es ane Ss / No 4 Music Goods Ordered by (OACKe | : | Flowers Bill Charged to f DR. e CR. <) 2B | ‘ 7 Z " | {) lI Uv | i | Fo JO Reh (lee, JO oO} pond Vk, Chott | Jo | | | - ' : \ eee SENSE = | \ } | | | ee | | | ——| i / i | i | i || | “¢ 1SBUEO BY COANTEER CASKET CO . BOSTON, MASS. 1810 RECORD AND BILL OF ITEMS FOR THE ‘te sea OF V Shereucelil Aaa () .7 fe Reor Total to date. / ‘¥ ). ype ety — Hebe F$- Yearly Ho. Residence Place of Deat!: Wife or Widow of ! Years Sex Wrele Months 4 Single ed Color or Race —— 19°10 Age 4 Pw. | Date of Birth Date of Death Maiden Name Days Married Birth-place { Occupation ; ji le) i \ po <_f oo he Name of Father ' " His Birth-place x) K LR O r C+ risa Her Birth-place Maiden Name ¢f Mother P — Secondary ae Cause of Death /. Cle 5 Ap aati exets — Certifying Physician Place of Burial Time of Service 211 Lr Pe Funeral Service at Fhe Lot No. Put in the P .agram one mark like this -~LVY hw ‘ | for every Grave in it. And mark this Grave No. Burial with double dagger thus : ¢ Designate site of monument thus: Date of Interment ude — Bo 1G PO Section | | CO Candles Sap Presa. Hond — Casket Coffin No. sof CBs Made pOxch Boy_e/ Lining/and Pillow Set No... Gloves Bearers or P - rs Hearse to Removal eA ow Corr. CH certs erred Handles Plate Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving . Services - Use of Chairs } | Transportation Charges Church Charges Officiating Clergyman Amount of Bill Goods Ordered by res Bill Charged to —* oe : V Cr. Cemetery Charges Music Flowers 4 dloo yy aie rea he, 00% OOW ilo oO ow oR ) "WO Meat bree | YOCO) Becy\7| Gua HKo Vv : | PT dha ‘a | + fae S | | |/ ¢| (r og Bley | | 4 | be aut fr HEE Sapir oo | ARE iE ane | | | | | j - | , | | Ziz 213 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS Yearly Wo. | Ys 2 FOR THE FUNERAL OF Tota! to date “ — Yearly No. OR THE FUNERAL OF oo: nak devek (adie aa. =e on AC oR. #b Residence Place of Death oe De —e Wife or Widow Oo “Pre ; . \ Nie. 2 a * . a 4 are eal oO te Es ate of Bi ° O 7 c » ace 0 1 a Z I ate ¢ irth poe i¥§ - O Years Color or Ra t F if 19 Oo Years Sex ia or Race Total to date LYE Residence (Day) (Yea Date of Birth Date of Death i l9ZO Age me ; r nee sig SO ee Caf (Month) . (lprie \\ Months 9 Single COL: 7 Pin ok Deal ‘ £ 1I9ZO “ Months Single 4 . Maiden Name Goer». \ Rive ieted ALEK : ” ) (Year) ; — . Maiden Name ee Days . Married (Mont Yedeove i ‘Cxmnelian His Birth-place bene Ree Bh & AC. sll saliaagi ie oO Ke Lou. & ALC. i Birth-place V< a LOG Co AOL ras ‘ — I Z Occupation .. ete sr ‘ ia Name of Father gaa * Wa ern 2_2_ step Birthplace AS ReekHe C 3 “A [(? ? on CH : : ‘ he < oo Name of Father Maiden Name of Mother Phi fa KQe San Birth-place nA ame of Father Maiden Name of Mother Cause of Death— Primary x. Secondary pe oe 2 : os a Cause of Death rim Secondary Certifying Physician CS tes Residence, Oley Lk a te ( heeds ae : ; Certifying Physician Residence 4 Place of Burial Le 7 c 5 , Place of Burial af Cemetery Funeral Service at CRA c a Rw ee ant ‘~ / / Put in the Diagram one mark like this Funeral Service at Lot No. Put in the Diagram one mark like this Time of Service € 0 ae ie - Grave No. | for every Grave in it. And mark this ‘ . | for every Grave in it. And mark this Sie of Sat : 2 2 £4 “ 4 < y Burial with double dagger thus Time of Service me : Grave No. Siaiel wlth dalle Ge ats ate of Intermen : j Section : secti f ] Designate site of monument thu Date of Interment ‘2 Section i] Designate site of manument hes: CI + . cineaiaiiaia ea societies i ili = a2 = = — rT] Casket or Coffin iy iain /O O19 g Candles Casket or Coffin No....V—~ Hha5 i m v Oo. Candles | i} Size Made |) _ | oe | | | Gloves I Size Made by Gloves I] Lining and Pi Set No. I aii cp Shai || i] eee et oe Bearers or Porters i + Lining and Pillow Set No. : | Bearers or Porters \| é “s | mre | 7 | Handle Hearse to i fi ee Hinvan to | } | | | late Plate Removal | tikes | Removal I Outs : « oO t | “Oz i i utside Box or Vault Coaches | Outside Box or Vault | Coaches i] Burial Suit Buriel Suit i i | od a | urial Sui i Slippers ; V | “ll Newsies Tevet | i| a | Newspaper Notices Slippers I Newspaper Notices i} Embalming Wye 0 I Embalmi | | | | } Em baiming | | | ‘ashing and Dressing | | Washing and Dressing Washing and Dressing | | Shaving ges i I o | | Shaving i | | Services | : i} I | Services i | | Use of Chair | t ; cg | oe | i eee | Transportation Charges Use of Chairs \| Transportation Charges ap | Church Charges Officiating Clergyman ‘ Church Charges | Officiating Clergyman | it } 8 8) H ncsisimebiei Slain church Charge | gz eat a a i j sence ' eee | | Cemetery Charges Amount of Bill | VY O.9090 Cemetery Charges | | Amount of Bill f O Ccetl ——— i : | _ } - i | i | - et ah Music Goods Ordered by nen aa a ; Music... i | Goods Ordered by ° C € teem] | | Flowers Bill Charged to tn ; Flowers | Bill Charged to ’ s = oe mecorxes ames: DR. pe CR. DR. - CR. wn ee —-) YE CREF Tate] ln -1 | Opa i yf 7 ee VA ann le @ / Wo Ce-tad Fi at 2 / . | ——— | VIOO Cre ae et, C/N . | | “AP Mech LEE4 7 ‘4 sacar ~ | aoog — | | 1) ee | ave j | | | | —-.- sa | sa 4 | 4 aaa Py | | 7 | | | | | —| | oe + | a | | | } | oil 4| — i | | | | I 7 | | | | \~ sane - | li . | =| i _| i} i | - l = | | | = | | | fs Lana | ———_—_——— 4 -| Aci) | pilmiioem ie | | | | | | | | | | . | —— ” eZ > ERS (FSS A Vee a {—~ —-}-— +- TEN ail MNS oa sa so i | | | | j i | | _ g | an on cen cn | | i aiaensniiiaiiaa tibia | | | f = “ ISSUES BY CORNTER CASKET CO, BOSTON, MASS. 1910 S f ange Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden ak of Mother Cause of Death Prime Oe Certifying Physician RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota! to date Va Wife or Widow of — . Y i Years Sex Secerale Color or Race 7. 19 20 Age Months Single (dix, . (Day) (Year) Qa Days | Married 7h Webb Co —Ke- Nena OL a - Occupation His Birth-place Pepe eG re. Her Birth-place Secondary Yearly No. Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Méther Cause of Death — Primary Certifying Physician / > eek F Wife or Widow of (Month) RECORD AND BILL OF ITEMS FOR THE FUNERAL OF €s0) wo ALE. Sex a eo oa — AC upation __-His Birth-place ler Birth-place Sec ondary Months L Days Single [ / Years | | Married Place of Burial ; Residence Ee are ms = étery % fi Lot No. Funeral Service at Put in the Diagram one mark like this a MM, Aeoste Residence , —— Place of Burial Cemetery Lot No. Funeral Service at Color or Race Put in the Diagram one mark like this Time of Service Grave No. I for every Grave in it. And mark thi Burial with double dagger thu Date of Interment Section Designate site of monument thu [ ] a neeneree Se = ’ Casket or Coffin No. Candles Size Made by Gloves {| Lining and Pillow Set No Bearers or 7 orters. {. bp \| ~~ Handles Hearse to Lge {ho wY<e_ | i ca Ae) Plate Removal Outside Box or Vault Coaches Burial Suit | Slippers Newspaper Notices | . | Embalming | Washing and Dressing | Shaving | | Services | . . . . Use of Chairs Transportation Charges Church Charges Officiating Clergyman ak ee Cemetery Charges | Amount of Bill acinus Music Goods Ordered by Flowers Bill Charged to DR. CR > ' , . > —=- | | tdomuds Jdnie dolow || « Vr | CGO-6€ 2200 a (itl Hie cece wtf | | | | } i I | \|- : | | ! | aie j | i} i i -| ll “ | | _| { | | | | ! | et | | | | \ | | j | | anne | | ! | | | sn ~ | { | i] - i | ne ey a ay —| | 5 So | , | | bm | 1SBUEO BY OORNTEE CAEKET CO. BOSTON. MASS. 1018 Time of Service Date of Interment Casket or Coffin No. Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers ae ih S on. sa | A TP DQ section 6 0s can 2 Candles Gloves Bearers or Porters Hearse to . Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by Bill Charged to guts | for every Grave in it. And mark this Burial with double dagger thus : f Designate site of monument thus: 2 | | eel be wee DR. “a sone ck Eee. Pr] a | | | | | | ISSUED BY DORNTEE CASKET CO. BOSTON, Mase... 1816 seis ss a er Residence / Place of Death OR THE FUNERAL OF x : -. 7 mas C- D BILL OF ITEMS Tota/ to date / g q breke hl date of Birtl us (Su ee Date of Birth oo an 19 eo | Years Sex : Color gr Race Date of Death . ly veo Age Months § Single Maiden Name _ Birth-place Name of Father Maiden Name of Mother Cause of Death Primary Certifying Physician Place of Burial Cd bivted____—_. Funeral Service at Time of Service Date of Interment eg / 6 /20 | Married \ Daas Occupation A His Birth-place er Birth-place econdary Residence Cemetery Lot No. Put in the Diagram one mark like this I for every Grave in it. And mark this Grave No. oo Burial with double dagger thy Section Designate site of monument thus: 7 Casket or Coffin No Size Made hy Lining and Pillow Set No | | Hearse to | / st 0° Candles Gloves Bearers or Porters baa? Ses oo Handles Plate | Removal I Outside Box or Vault LSO co Coaches | Burial Suit | Slippers Newspaper Notices Embalming #5100 Sloo Washing and Dressing oo Vay 3020 Shaving Services Use of Chairs Church Charges Cemetery Charges Transportation Charges # Officiating Clergyman Amount of Bill Music Goods Ordered ”) ap Flowers Bill Charged to 4 DR. cr al hug (f| Booind Bahl) 3b S00. < | seepe cae. + | _=* “I i; _|_2©d1 | 4 _—— | | I" | | | i | | | i ~—- _| ; | | on == Be fe al ¥ 4-H | | | | | | | 1S86UE0 BY DORNTER CASKET CO. BOSTON, MASS... 1916 a 4 7, Yearly No. Vad Kesidence Place of Deat!: Date of Birth i (Moath) a Date of Death Maiden Name Birth-place Name of Father fae oe Maiden Name of Moth Cause of Death— Primary Certifying Physician Place of Burial Time of Service Dat of Interment Casket or Coffin No. Size Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving . Services Use of Chairs Church Charges CemeteryCharges Se fae Bows Fromae- Funeral Service at Bowe kh S. A. : 1Q;0 6 QA. “mM RECORD AND BILL OF ITEMS FOR THE FUNERAL OF tn —, =~ Seow 2 oe Age Years Sex a (Year) Tota/ to date Wife or Widow of Color or Race Months Single AP atiran0lo L Days L Married Occupation ; His Birth-place Her Birth-place Secondary Re a “nce AS ptery fer o89 No. Grave No. / g (920 Section Candles Gloves | Hearse to i | | Removal Coaches Officiating Cler } Amount of Bill Bearers or Porters Newspaper Notices Transportation ¢ -'. gvyman Sree 2@ G a4 ofLiusrod Zq Put in the Diagram one mark like this 1 for every Grave in it. And mark this S Burial with double dagger thus : ¢ Designa e site of monument thus: C) _ Music | | Goods Ordered by . La) | Flowers Bill Charged to fee cect > eran eats omen _— - DR. CR. V9 he or Sheen) Slog Mey oe MITE M e 188UEO BY DOANTEE CASKET CO. BORTON, Mage. poe Si ee mae _ aa tA Eee rene nent ee aed Wns 218 RECORD AND BILL OF ITEMS Yearly No. /. F Cay i latiinlic “he Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place E Braz Name of Father Maiden Name of Moy oe r Certifying Physician yy) Cause of Deatly7 Primary a eg Place of Burial Funeral Service at Time of Service Date of Interment (Mooth) fi oer: (Day) FOR THE FUNERAL OF Tota/ to date ae Wife or Widow of ha LQ 19 OO ) = c Years Sex " re — Color o Race (Year) 9 19 oe, ) Age Months 4 Single fed Bere ait oy ye whe Residente Qe Z Days Married Occupation F Oy nesr- His Birth-place of hu Attit_ * Her Birth-place ( ob hen othki. G - A@/) » Secondary Bea fez. ace. bhiet— a Lot No. Put in the Diagram one mark like thi | for every Grave in it. And mark thi Burial with double dagger thu Designate site of monument thus [ J 2 { Grave No Section a OE Casket or Coffin No T he Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers hee _la~ CLL 2 ory Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Je ©. Candles | Gloves | i| i Bearers or Porters, | + | Hearse to. 7-xaK ho ck | ASico Removal : Coaches | / S\oo| Av oq Newspaper Notices | Woo | | i \| + Transportation Charges { | Officiating Clergyman Amount of Bill Music Goods Ordered by / Lt : (yaw {: Flowers | Bill Charged to i “ i AOD Aix. DR. «GR. slo ark /Lelo (Yue oer, \fee Abe, Chaney ¥ Md ,mano | ’ hed — - | I | } i —- = | | | i | | | 4 | | | | | . a | | | j } - ns | | | } } i | | | | wii | | i] | | | j as - | | | | | | tl {ISSUED BY DORNTER CASKET CO, BOSTON, MASS. 1016 219 RECORD AND BILL OF ITEMS (9 FOR THE FUNERAL OF haem Seen Yearly No. jim Tota/ to date / N Residence Place of Deat!: Wife or Widow of. ? é sa Date of Birth o cr J = G a. Years Sex aspee.. é Color or Race JAA. (poi (Dag) i é Date of Death J me O g 47 Months Single sa LOthete—~ onth) (Day) Days Married rae. AGEL OP aA oO tle CK « Maiden Name MRL. S. a Ke. epee (2 eee lor 4a fC, lis Birth-place he. Natvtins Her Birth- place ¢ ahhev Secondary ’ 7 of Ja € Lenn a2 ~~ Residence —. Birth-place Name of Father Maiden Name of Mother Cause of Death-— Primary Certifying Physician. ; 7 : 5 \ ay GZ illlciltsisiil el i . ) Place of Burial - Cemetery / Funeral Service at etn Put in the Diagram one mark like this Lot No. | { for every Grave in it. And mark this Burial with double dagger thus: ft Time of Service ft JO : or Grave No. < ) Date of Interment ae 2 Section | . we No. gv Ika2pD Candles Casket or Coffin ! Designate site of monument thus: cs Gloves Size Made by Bearers or ee, i ' Hearse to a Se al ane NE 7 Fae yv Gr Lining and I’illow Set No.. Handles Plate Outside Box or Vault | Coaches i 1% | Burial Suit o ylase Slippers i} | Newspaper Notices i} | Embalming I } I | Washing and Dressing | JAD | i| Shaving Services op Use of Chairs Transportation Charges Officiating Clergyman Church C a s | Amount of Bill 4 +7 Goods Ordered by id 7 oe Bill Charged to 4}- he cha Ye} ‘ oe seman tt tim 8 | Cemetery Charges Music Flowers DR. CR. Moat [ace | 7Iea AIH a ty Caph. POI 1103 Sad , | \ Be A li? fo co | | | ! es | | |__| | | ] | | 1} | i l 7 i oat {| | | i] I} | | | | or | a | | | ‘ ee 1 al 4 . | poe | e | | | - : ; illogical nical | | | | <r i Ole 4. adnate TSS STC . nh Hi ni i} |. SET roe 220 Yearly No. {5 2 Residence Place of Death Date of Birth (Moath) Date of Death O Month Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment A A SE OTIS ET a Ca: ket or Coffin No Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date tit, Jee 0. LEE LTE ity Lebo (Bite Creuse Caeuk, 37 Cu ass Wife or Widow of 19 : Years Sex Color or Race it he Months 4 Single 3 Days _ Married Occupation aR His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. | Put in the Diagram one mark like thi Grave No a Section | Designate site of monument thus: CJ | ae dnenieeiiiiiaiaa = Candles Gloves || ' | | | Bearers or Nee 4 || Hearse to,../ Le) - /) a aia ce Coaches / Burial Suit i Slippers Newspaper Notices } Embalming i Washing and Dressing | i Shaving | i Services i | Use of Chairs I Transportation Charges | Church Charges i| Officiating Clergyman Weeds a Pe Cemetery Charges i Amount of Bill , p sseicceeaai - Music } Goods Ordered he Flowers Bill Charged yA r DR. CR. | | OT “I She] fon0 he CLC ~ i Vio } | \| ' wel | oe =a | 3 1} _ | i | ot | A oe | | } i} | | ij { | | i| } | | | | | | ¥ | | | | cman | | | —-| } | Pod | | i | a | | i} | : | | shies df seihiiili is — - - | ” | J | | | i | | | ISSUED BY DORNTEE CASKET CO,, BOSTON, MAGS. 1010 ~~ RECORD AND BILL OF ITEMS 221 1$ LL Tota/ to date Color or Race Yearly No. FOR THE FUNERAL OF Kae. pf Z See Residence 7, lets Uribe, CLe Place of Deat!: fee ¢. Wife or Wid of Date of Birth 19 [ Years Sex (Month) (Dey) (Year Date of Death 19 Age Months 4 Single (Moath) (Day) Year Maiden Name | Days _ Married Birth-place } ta 7 Occupation Name of Father . a. His Birth-place Maiden Name of Mother . Her Birth-place Cause of Death - Primary J Secondary Certifying Physician Residence Place of Burial Cemetery f Funeral Service at Lot No. j Time of Service Grave No | ) Date of Interment Section Put in the Diagram one mark like this { for every Grave in it. And mark this Burial with double dagger thus: } Designate site of monument thus: Cl] Casket or Coffin No. Candles Size Made hy Gloves Lining and l’illow Set No... Bearers or Handles Hearse to Plate Removal Outside Box or Vault Coaches Surial Suit Slippers Newspaper Notices Embalming Washing and Dressing I Shaving Services Use of Chairs Transportation Charges Church Charges || | Officiat’ng Clergyman 3BV10O | (QQ. C1 21. Las, j Y | 2 SOS Se AR SET AE TT ATES - ates oe we CR. . | a Cemetery Charges i| } | Amount of Bill I Music i] | j Goods Ordered by {| Flowers Bill Charged to , DR. ' ot inataeiilaeaa | ; aS |__ fO@ecer (222g, : oI + tt — a — 2 | a — 4 | | | | | | | | | | - | . | a } — j | j ] a = | | _" ai — | 4 | Ld a i i | | i i} Bees seid | | is Kaa So OOo SE aioe. 1S8UEO BY DORNTEE CASKET CO, BOHTON, Mase. tere Sean ancy ae enaeormarsnnsarreer sseneensceenernontmronna si ae Aim igor ae saan enna ae enema Faro N ns serene et De sono eee sie or rv ig ss RECORD AND BILL OF ITEMS FOR THE oP OF Wife or Widow a Tota/ to date. Yearly No. [55 am Residence Place of Death Date of Birth ay 19 Years Sex Color or Race (Mgmth) (Day) (Year) Date of Death vo fe rT 19.2 O° Age bars, paonths Single “yes Z : (Month) (Day) (Seen § : Pk ob Maiden Name /v Days Married MWeRe eg Coe ~K.e- Occupation WN et -place irth-place by Secondary ees Certifying Physicia © ig. Residence A FOR rev Le Place of Burial a it. tras Ol neler Lot No. Grave No. Birth-place Name of Father h Cafawbe- & bo a a RFE Maiden Name of Mother | Cause of Death P ae? Funeral Service at Put in the Diagram one mark like th Time of Servi | for every Grave in it. And mark th » of Service ; Burial with double dagger thus .. Section Date of Interment : Designate site of monument thus: oe \ . 7 loa Ta ee 1 = ' . me Casket or Coffin No 7 a i = ve. Candles Size Made by | Gloves Lining and Pillow Set No. | | Bearers or Porters | Handles | | Hearse to Plate | Removal Outside Box or Vault | Coaches Burial Suit | | | Newspaper Notices Slippers Embalming | Washing and Dressing | | Shaving i | Services | | | Use of Chairs Transportation Charges | Church Charges Officiating Clergyman a Cemetery Charges Amount of Bill ie Music Goods Ordered WP f.4 teaiiae Flowers | Bill C harged to / $44 Left — J } \ DR. CR. T 7 al J i rd i } Lh eil } 7 14 | a . | / i f ye Ut ) a Le ONASOAL yI } I K~M4/ | & K, H Saal C bi alec : Q ce = — 1 - Si amaenl i sinilltscalltcieee +. SL EAL St i at a | . | J | Ld ’ i | | | | | j | | i] -—~- | | Ps | } : | I | a | | 4 | | | ISSUED BY CORNTER CASKET CO., BOSTON. MABE.. 1010 ~ bm | a RECORD AND BILL OF ITEMS Tota/ to date / J © — Pe , FOR THE FUNERAL OF & C Bir f ia Residence LOtut KL; tfare.l_— ec je aS \ (Month) (Day) (Year) ve fpf v 192 onth) (Day (Year) A bigy Cer 7Le ~ Name of Father Keev cs Le ¢ Birth-place Maiden Name of Mother Sav LOeeeg Ce reece af, Birth-place Secondary Place of Deat!: Date of Birth « a Widow of re Veers Sex Iraks Y Months 4 Single — Days Married —- fatukos L£-od- P< L cco & Ae Pr~-Z22E €O HE Color or Race LM (VS hafe'ex _ Date of Death | = age Maiden Name Birth-place Cause of Death— Primary Certifying Physician 4 Residence U Ak BH £ J Chae eat Cemetery Lot No. Place of Burial Put in the Diagram one mark like this 1 for every Grave in it. And mark this Burial with double dagger thus : t Funeral Service at / Time of Service 9 Grave No. } Date of Interment - Se KF / xe Section Casket or Coffin No... +74 Ory - 00. OO Size Made by Designate site of monument thus: Cc) Candles Gloves | Bearers or Porters ; Hearse to ‘ cereal [ror Plate Removal ; al Outside Box or Vault 5 '| “Coaches ah - . i} : A ; Burial Suit Lining and Dillow Set No.. Handles Slippers i] Newspaper Notices Embalming Washing and Dressing H Shaving Cemetery Charges Services | c Use of Chairs | | Transportation Charges Church Charges | | Officiating Clergyman Amount of Bill | \CC 4 tata € ia Goods Ordered by Music Bill Charged to a Flowers DR. es Crete, _ | | se | LOSTOM, MASS, 1018 ee 2 gain aa a iE | 1@SUEO BY DOANTEE CASKET CO. 223 eon . ereecnnnninenannentnmemenenenet ania an a SSSA SS SSS SSSI STR anemones ’ : 5 & ¥ f : ra ear ee Se ee eee ee eee - Tt ee sre eR ERESEP RRL NE aB De pe ernment seta 224 RECORD AND BILL OF ITEMS Yearly No. (§1 ai | Ico dy<dheeg Name of Father f 7g LQ Residence Ahn Place of Death Date of Birth / O° (Day) Date of Death Maiden Name C Birt h-place Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment aati a (2 220-— Syh (Ure FOR THE FUNERAL OF Total to date Ze — Widow of $53 Years Sex Color or Race (Ygar 19 yo Age G Months 4 Single (Yeor) Days Married M14)" ; CO ne Occupation His Birth-place Her Birth-place Secondary Residence 4 Commatery Lot No. Put in the Diagram one mark like thi | for every Grave in it. And mark this Grave No. Burial with double dagger thus : 7 Section . : Designate site of monument thus: 2 Casket or Coffin No. v SLBA? Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges V5 0 Q)) Candles ; | Gloves Bearers or piers | Hearse to Removal Coaches Newspaper Notie f ANY / JRC | Transportation Charges | Bs) Lo i} anspc Ne Bs A “ i| {| : | fe sr r I | Officiating Clergyman } Amount of Bill ‘ G PFS i | Goods Ordered by | } oO ef Music \| | ~ | Flowers | Bill Charged V2 bees, of 62 Ite “ 6.0.0 OO 2, pty" HBT MER, on. LO Re bee Ary 7¥1 5 cee a fo aah ee ae 5 - ee Puck J r | - | | . “a | a | a | | 1 al " - anid _ ; i 1} aan ~ | en - } i| I — | i er a ee a ee a ————— ~ — en ee | eee | aera = sone eae el LT | 1SSUTO BY DOANTEE CASKET CO, BOSTON, MABE. 1018 pe teasn ners pee asa RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF Tota/ to date 15 § L : O-%e_ Ca Residence ockén Place of Deat!: Wife gr Widow of Date of Birth JO Years see MALO Color or Race (Year * Date of Death 1920 Age Months ¢ Single a (Year Maiden Name de. eae $s Bogue HD Gin or His Birth- -place Birth-place Name of Father Liste, REZ Maiden Name of Mother. Birth-place Cause of Death—Primary ondary Certifying Physician Residence Cemetery Lot No. \ Grave No. Place of Burial e Put in the Diagram one mark like this {| for every Grave in it. And mark this Burial with double dagger thus: ¢ Funeral Service at Time of Service { ~~ © Section Date of Interment / Designate site of monument thus: ie Made by Gloves Casket or Coffin No. WONT Rig 00 co Candles } | Size Lining and Pillow Set No..... | || Bearers or Porters <a i! I wt be 4a Daw ef. fs DO Handles Hearse to Plate | Removal | J-NLeac. 1 ogo | Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming VS OOo Washing and Dressing Shaving ...... Services Use of Chairs Transportation Charges | Officiating Clergyman Church Charges Cemetery Charges Amount of Bill Music = | Goods Ordered by Flowers Bill Charged to DR. CR. ‘ah ' i 4 2. ( Tn -O A (CY Rr A Coon pr [ez -__| sooyo hei eu Sa 1 pee | Pet, AY “i . IHG F4 oo | een Dineen =| | | aoe socal — | | i } } | i| | i ' ' ; | | dk | Le ISSUED BY DORNTER CASKET CO, BOSTON, MAGG., 1018 j ne oo RECORD AND BILL OF ITEMS Yearly No. / een FRR THE FUNERAL OF Bien j etn Wife or Widow of Place of Death —” (oO Residence Date of Birth 19 of Years (Day) (Year) Date of Death : 19°ZOA 0 Y Months Maiden Name Married (Day) b. az = Days i ae His Birth-place Her Birth-place Birth-place Name of Father Maiden Name of Mother Seco adary Residence Certifying I es 4 i “We Cemetery Place of Burial Cause of Death— Primary Lot No. Funeral Service at Time of Service Cree Ba. ... Section ea Ye y Date of Interment wheal,’ | — Te Whda Tota/ to date \ ( ‘olor or Race Mews, Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: ¢ Designate site of monument thus: [ ] lech Gul PF L316 "OO Candles Casket or coffin No. } / Size Made }y Gloves i | Lining and Pillow Set No. | Bearers Ie Porters rh Ba | i } i} 4) a h 7 j ; i Handles | Hearse t WL 4 - Pay VAL, 4 Me Hh Plate | Removal | ai} Outside Box or Vault 7: OO) Coaches | aie i ie Burial Suit i| / Slippers Newspaper Notices i| Embalming RISO | : ' Washing and Dressing . | a | fs Shaving } ; | if Services } ii Use of Chairs Transportation Charges . | Church Charges Officiating Clergyman Bc i | my 4 Cemetery Charges Amount of Bill fal eo i | Music | | Goods Ordered by | i | i Flowers | Bill Charged to 1 DR. 3 CR. > ae TF > J oa | i ri i si 1 , - } i Z i. y og ; COAL V4 era) 7K Oleh ap i CK 2 ale 4 Bv igo ee ee 7 | ] —— | ies | || ——— ae { | ae | — } | | | | i : | = | | i} on j | i s isis 1 = | | —_ ! | | —~ 4 | | : t a | ‘ |. Zz | \| } - -| i a i : NE | idea jo | | rer f Se oe I aad a -cliinniiesncandsliaiet a ad on - | — onl oni ' correenenemennel “7 ene eo “ - si | | | ISSUED BY DORNTER CASKET CO, BOSTON, MASS... 1016 ahs 227 RECORD AND BILL OF ITEMS S60 Tota/ to date 7 Yearly No. FOR THE FUNERAL OF Va MIO eae Residence Place of Deat!: rae Years +r Months 4 Single a p : { a Married Zo 3 44 / ie... eaten é His Birth-place Wife ie yo idow of Date of Birth Color or Race Date of Death Maiden Name .{ Birth-place Name of Father Maiden Name of Mothe Her Birth-place Cause of Death ary Certifying Physict Residence Place of Burial C vemetery Funeral Service at = Lot No. Put in the Diagram one mark like this Tin af Service , / Crive No. ' t for every Grave in it. And mark this ea, 7 Od ; Burial with double dagger thus : ¢ Date of Interment Section , ree Designate site of monument thus: Cl Casket or Coflin No¥ Candles Size aetehilsccuu ee a Gloves Lining and Pillow Set No...... Bearers or Porters I I 55 ede Hearse to f- . | | haw Ker | : Plate s : i| - Removal aw | Outside Box or Vault 2 eee / SO ©) Coaches j ry, I | { Burial Suit LM i J 5 CO Slippers | ‘A Newspaper Notices Embalming «9/0 0} Washing and Dressing | | Shaving ... | | ij | Services | | i| Use of Chairs i Transportation Charges Church Charges ! Officiating Clergyman f Cemetery Charges | | | Amount of Bill f a ,— Coto. Music... | Goods Ordered by A. ( MW 20lae. | ‘ Flowers ' Bill Charged to ( ee | f : ed, DR. ; CR. eff JO Mew k (ever 6 oT «. Ey (3/24 Jk, Lbhus_@hk _ Gorxwv | —| + « | | 0 | : | * | 7 | i | il ~ es | | i | | ee me | Pe ae : wee | be | act “|} | | | | sania a j i ad Seamiaiel Eo ) . i | i | > a on 1 4 | oo 3 ees i aa —|——|| — - —| — é ‘i (iceniesiaaiiaiical — | | | i | sn | i i (S8VUED BY DOANTER CASKET CO... BOSTON, MASS.. 1000 piisinttaerarapettranssmemanndinnraian 228 % 229 RECORD AND BILL OF ITEMS RECORD AND BILL OF ITEMS 7, ov Total to date nw. of oe: FOR THE FUNERAL OF Total to date f Yearly Ko. FOR THE FUNERAL OF “,*- ate ; Mnovg auf me ; 0 3 Résidgnce =o Mikhael ean, AG Residence Rh. t . Wife or Widow of Pion of Dasth Wife or Widow of - ci “Color or Race Place cal Death Drynqatte A Thad ¢d Years f Sex ’ 7 a Date of Birth 19 Y Se tie sink Tins ei | Date of Deat! 26 19 ZOA a causes on (Mouth if (ear . ate of Death —t a2. | ges - onths 4 Single Peta of Dinath Qorc / 1920 Age / Months § Single 44 ° Da - Married : : Month) (Day) (Year) / f y 3 : : I Days |, Married | aTee SB RRR Pet, +0 : Maiden Name Siti Maine / i Bisth-place Occupation Birth-place Occupation ‘ i ‘ Name of Father His Birth-place Manu of Vather His Birth-place Olaccha CS AE | : Her Birth-place Maiden Name of Mother ay i oe Her Birth-place erprnae hee Se . Maiden Name of Mother ne races — Caus Death— Prime Sac ii suse of Death rimafy ap econdary : ei: le aia Mika Sedan at Certifying Physician Residence Certifying Physici of, LA Llp aes wg)T \aiane lace Place of Burial PM flown vemetery ij Moy/uxz | Cemetery Place of Burial 1 Funeral Service at e Lot No Put in the Diagram one mark like this Funeral Service at ci Lot No. Put in the Diagram one mark like this ' a , ‘ . tae -. 3 < F s ie _ Hy Time of Service // Grave No. etre tench eg ~ 56 - Time of Service ~ Crave No. : { for every Grave in it. And mark this i M Z ao oe ; , Burial with double dagger thus: $ \ i) Date of Interment Section i lias ise) af Tainan B&B ef Zwlee Sabian | i Designate site of monument thus: [ ] ate 0 . : | Designate site of monument thus: _ a. ae ; | | f | sc I | 7 / | ban : ae : 70, ; _ | Casket or Coffin No. Candles \ f Casket or Coffin No. Fire 000 B-ae vIb—A [> oo Candles | : " , i ; : Size Made by Gloves i} Bien Made by Gloves i| ' | | a ae ; : | | ; i] a Lining and Pillow Set No Bearers or Porters A Dg q Lining and Pillow Set No... | || Bearers or Porters | Handles Hearse to f Ve Ussryal, Oe weg — oD Handles Hearse to | 1 / Z 22 Q ’ I| : ; —_ Remoes Wt a - 7| Plate | Removal {| ; | i a i Outside Box or Vault | ( any Ao) Outside Box or Vault i | Coaches i] i Sat : al (te bULover doo { aa 1 Burial Suit | i} i Burial Suit a Nd (eLren~y Sec | lLiec | Slippers a Newsp. me ~ if at . | Newspaper Notices {| s 2rs co v/| _—— | i \ Embalming A @) oO} 1m ictal . I ot 6 | mbalmin { laf i a poalt 2 20 © i | if Washing and Dressing ¥ Washing and Dressing | | | 4 Shaving : Shaving | | | Belics | f ; | ia’ Services } 1s Services | | 7 } (if. Paathe feat JO J ; ssn | | } Use of Chairs i] Transportation Charge einai i Use of Chairs i| Transportation Charges | i| | Church Charges | Officiating Clergyman a iy 4 | | Church Charges Officiating Clergyman z= : | iq > 5b i Bi —t bd Cemetery Charges | | Amount of Bill D niigtll : i } | i Cemetery Charges Amount of Bill Goods Ordered by Music | Goods Ordered by Music | Flowers Bill Charged to ou Flowers Bill Charged to DR. , CR. DR. CR. 7 2a ols . pt Wee — 7 "7 re SW), ae one : | T S@e@ cI A A 98.BS | OLY [yp Deg Ste |) (ety | Jo émn Bren | sv eee ) | Come — | fee | ical | | pew ae | | | i | bain | se | | J | ie | | | is | | oe = | # | | : ie " , iT a is | | | | oe | i | | | | 1} j ™ 4 ; i i i } i | | | | rt | 2 H | | | | | bs | | | — \ | i i | | | | | | |— = =o - | | “a | | | | | ] | co. oe a i { — —| | | ‘ | _ ~y : iii a is H} | ai | is | | | | | | | Cg | . a jm a lleiianaiianeneniiiaiatiin | —|—— ‘ | 4 ela | ENE i : | a ilies ‘ san | | \ | 1S8UEO BY OORNTES CASKET CO. GOSTON. MAGS., tOTe 18OUEO BY DORNTEE CASKET CO, BOSTON, MASS. 1016 — eect eerie ie eeeaene te reer terreno NS ae 230 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Residence. b, Weta, Place of Death aoe Un Date of Birth ; le Month (Dey) os (63 Yearly No. | Tota/ to date Wifg or Widow of 7 oa fie Dake WNT Color or Rac t (Year) Date of Death 192 © Age Months 4 Single . Month ) (Year) Maiden Name V7 Days Married 4 Rud manny a - A Ey Pa Cities hear Birth-place Name of Father His Birth-place Maiden Name of Mother Her Birth-place . Cause of Death— Primary Cimnabh-wtmn Ceo Ge_e-._& 2e_¢— Certifying Physician Ay H}- Ae. / Place of Burial [News paler / / Funeral Service at Time of Service { { Qa Date of Interment Residence Cemetery / Lot No. | for every Grave in it. Grave No. Burial with double dagger thus wig a — / >) ©2°. Candles } | Gloves finn | x. a gt f Bearers or 7. ters pee | | | | i Hearse ao | ~ | Removal V0 cae To Fang, ? ¥5\00 Coaches | | | Designate site of monument thus Casket or Coffin No t1leye Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Su't Slippers Newspaper Notices Embalming ¥5/0 0 Washing and Dressing Shav ing Services Use of Chairs Transportation Charges Officiating Clergyman ; Pa ae ee a Amount of Bill 43 Goods onder fee eae af Bill Charged to' G Me Church Charges Cemetery Charges Music Flowers SHR | AB AJ~>~/ DR. oo act dene | Pouvel pry upd | eietemetiecnneth ! ' ; ; : instill eiiiiilinccemicassniinlbasstiion demi | nn —_ — — | Put in the Diagram one mark like And mark this this CJ 1S8UEO BY OCORNTER CASKET CO. BOSTON, MAGE. 1818 ——4 231 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF fart Cen) + abe er cad I Shy uae $Y f yas Yearly No. Tota/ to date 1O$¢ Residence Wife or Widow of aoe. Years {Sex Nhe Place of Deat!: Date of Birth Color or Race ao (Day) (Year) | J, ‘ Date of Death oer 3 19>2- O Ages Z Months 4 Single Aeegle TOR the Month) (Day) (Year) : ‘ Maiden Name | 77-2. Days | Married Occupation U ~ His Birth-place [EL RAO serie & A CL Her Birth-place ¢ yeh €£L Ca A e_ w Birth-place gt sl Of Name of Father so Papel Maiden Name of Mother Cause of Death Secondary Primary = ab coer OY Certifying Physic WR Ww eS Residence Place of Burial os r a Cor aan Cemetery Funeral Service at Lot No. | Put in the Diagram one mark lik. this — Cc ° f Pi N i | for every Grave in it. And mark this oe c oe —- eer 4 Burial with double dagger thus : ¢ Date of Interment Oo Lee Section Designate site of monument thue: C) = * Se i <2 IER T [Aw / V5 a Candles Casket or Coffin No. Gloves Size Made by | Lining and Pillow Set No... Bearers or Porters {i | | Handles | Hearse to i late Removal i Plate | i! } Outside Box or Vault Coaches Burial Suit Slippers i ) ‘ Newspaper Notices ; (IQ @ TY d (Q-« | | Embalming / ) eenate, /, ‘ ~! | | Washing and Dressing | | Shaving Services Use of Chairs bh ransportation Charges Church Charges | Offx ating Clergyman “3\Fo Cemetery Charges | | Amount of Bill | / ) es Music | Goods Ordered by | | | Flowers : | Bill Charged to DR. CR. isin 1 Las ow “Q2a 2 x% Rene J AGA “a ot ‘ Aide, a 1 ] nea Fed vo 196UEO BY GORNTEE CASKET C@,, SOSTON, Mase., 1e10 isi gual at 232 Yearly No. (. 5 XL h — FOR THE FUNERAL OF Lit a4 6. Kha > er ~ Residence Place of Death parts ( ‘o : bat Occupation Ory UAL ty | Birth-place | cy fj - , & (Cc CY L Name of Father / aX f—.| " ; tr & -- ~.His Birth-plat ; Jia ; Maiden Name of Mother ‘ary f Cpe, Cb -thpi th. -place i] Cause of Death on \F VO 0 Secondary — 4 | en x U a Gl. : Certifying Physician - Xesidence " A Place of Burial ( )g. % & ” Oo wot Cemetery J Funeral Service at iad Lot No. +, Time of Service ; A~ vo Grave No. Date of Interment Section Single U/ LAD Date of Birth [Os ls if 8.5 e i Years Sex Monthy (Day, (Year) Date of Death o¢ 5 1XVO Ages. Lf. Months (Month lay) (Year) P - Maiden Name / & Days Married, " RECORD AND BILL OF ITEMS Tota/ to date me _-Wife or Widow of &< Cllrs alo . Color or Race OK Aha pls. Hirde, C0--A x Hehe & yg Se “Nha Ca Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: : Designate site of monument thus: } ] ee NT en ee rene =, Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music Flowers / r Goods Ordered by Bill Charged to V A AANA AP Casket or Coffin No. f AQ» / 6-2 1@ | Candles Size Made by Gloves Lining and Pillow Set No. | Bearers or Porters : Handles | Hearse to ae ae A ( (QO) AL f Plate Removal 4 o i we € / | ' Outside Box or Vault ; Coaches ii Burial Suit ¥ Sd a J Go Slippers Newspaper Notices Embalming ? SJ o¢ [K = er (asst j CAR > ace / ; (S| IBS 0: “aan ¥ Wace gike f ? Feo) ORT z CR. Koa meme Cawk i} Rg CeeET 1 7fae Faia | af j 1S96VUEO BY DORNTER CASKET CO. BOSTON, MABE. 1018 gf rere 233 RECORD AND BILL OF ITEMS Tota/ to date. 5 66 - oe FOR THE FUNERAL OF fo. 2 (Fe Wass et (Ya fiche, A © eo a Yearly No. Ph Orv 47 S- Residence Place of Deat!: ae w of Date of Birth lo Years Sex ‘olor or Race (Mgath) Day) (Year) Date of Death Oo CL _—s 19 ZA Avw ad Months 4 Single (Month) (Day) G! = Been 3 CHee~ | Days Married Ral? g Seek Occupation BOvthedl? Heed Cad 4 Al ae he eee “His Birth-place Her Birth-place Maiden Name Birth-place Name of Father Maiden Name of Mother C2 Certifying Physician Cause of Death Secondary Residence eo es och Le A Comete ery Place of Burial Lot No. | Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Funeral Service at Time of Service Grave No. Date of Interment Section o¢€ce 7 fe od PPAR Size Made by Designate site of monument thus: a | Tee Yo O° Candles | Casket or Coffin No. Gloves | Bearers or Porters 8 V7 | Meo CdSp he fu | pr Cay s. +4 te Ceo & 4462 | | Coaches Kee E> || Lo {| | / oo? Praed Gx Aik ley lV A. Notices +-- } Lining and Pillow Set No.... Handles \| Hearse to Plate Removal Outside Box or Vault Burial Suit Newspaper Slippers | J imbalming } FI PO i} | . : i | lowe § eee ey eh he ctc ett Washing and Dressing \| shansentannsnataihansssasioes sap Rt | | rer Shaving i | Shaving | ! c a2: C 2 Le | | cate Ht : Services | | “HA aovyvev Ace, Use of Chairs | | Transportation Charges <A Church Charges i Officiating Clergyman | Cemetery Charges | | Amount of Bill 1 Music | | Goods Ordered by i Flowers Bill Charged to DR. W win : cee Wowace) Sea PTS - |= : ; ; | | | al | 1 4 | | | | | a | | | | | cs | ee cs | j | se | a a | | i ad ISSUED BY DORNTEE CASKET CO. BOSTON, MAGS., 1018 234 RECORD AND BILL OF ITEMS ' Po Yearly No. AQ Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of: Father — Bemoynd. £0 car, Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service ° eet a (40 Date of Interment Casket or & coffin No. 7 a sglEH] Size Made ww Meas Ke”, be Of 0 Lining and Pillow Set No. | ‘ e {I His Birth-place Maiden Name of Mother a Her Birth-place — a OHe Residence a ae emetery gee nents Grave No. Section /) FOR THE FUNERAL OF life or Widow of @ YX Months 4 Single “7 Days Years Candles Gloves Bearers or Porters | Handles | Hearse to Plate Removal Outside Box or Vault Coaches Burial Suit / 23 |O © Slippers leer, Mhrve VKrene_. - \JO Newspaper Notices Embalming | J ae d ; Washing and Dressing __Z t y Shaving . SKae Ff A VO Services eB: Use of Chairs Church Charges Cemetery Charges Transportation Charges Officiating Clergyman Amount of Bill Sex hace’ Married fers Music Goods Ordered by Total to date Color or Race Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : Designate site of monument thus: CJ rc en DR. CR VO Qeecke heen SOF OCL. (ik ( + kh Zh .. ee ¢t+° Flowers Bill Charged to } tt a (S8UEO BY CORNTEE CASKET CO, BOSTON, MASS.. 1016 RECORD AND BILL OF ITEMS Yearly No. ) oe , FOR THE FUNERAL OF / £ s AV Le fg 3 e fon “ffs. oe J f } Residence y WtdteMmetY '4/.,* J Ld AL - aA. 235 Total to date S64 Place of Deal's Ais bf L/ lr ANA atll 2 Wife or Widow of ‘5 y Date of Birth ( (0 et / iy b a Years Sex MA A t¢ C color gta neittin 2... io 1F Age Months ¢ Single... HM REG. (Month) (Day) (Year) \e “Ny 1 Maiden Name eis / Dt | Married. 7 cateat, Birth-place “4&7 a Cz Occupation... (/-t. e F....2 thd ta Name of Father ‘e .. ! CG Y Aww 4 a His Birth- Z f Maiden Name of ry y Her Birth-place Cause of Death Primary ~ yD sad Xs Kut ~<A Ther oat Secondary ws : : Certifying Physician. ae ae It, ds ' He r. Z (A--<t Residence. <=> Ca Ze Lied C : A Bo ' Place of Burial le x Me. A A. ae at. ae Cemetery Funeral Service at = ft, Ma tA. Laren Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark this jt 1! 4U.' Ctr RA Time of Service Grave No. / ler. gi cs Date of Interment Te ‘ Section ie iA | : Casket or Coffin No. LOO PC Candles Size Made by Gloves Bearers or B arte rs ns Hearse to Lge vw | SS Ns Plate i| Removal 7 tr] Aé Ur I Coaches / i| 1S \0C || Lining and Pillow Set No... Handles Outside Box or Vault Burial Suit ft cL Slippers i| | Newspaper Notices Burial with double dagger thus : ¢ Designate site of monument thus: CI Le. 4 Q\ pe rth. t pAct9te © Embalming | - f a Washing and Dressing | | | Shaving } Services | | Use of Chairs | | Transportation Charges Church Charges | | | Officiating Clergyman slit Cemetery Charges | | Amount of Bill > , A LE 6120 Music... | | Goouls Ordered by - Mh eh Flowers | Bill Charged to atate DR. CR. | TE hid PELE (66) ee lin ee Be | Neve g | pa : hchkt as {Too | | i —+- a ne nanEnmearS ‘ nnn aa 236 — Yearly No. / 6 Y Miran Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mothe (tA Qke “MV 70 Nehaa Bx eek Luk, toy» A reer Lr is 70 Casket or Coffin No. eK OR 7A, (Co ov Candles a Made by Cause of Death ( Jertifying P hysici lan / Place of Burial Funeral Service at Time of Service Date of Interment Size Primary Vetinke / LbeT 50 gerbes |? yer LO tk, RE. upation WR Lee L004) | Lae Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers RECORD AND BILL OF ITEMS FOR THE FUNERAL OF MM Mi ouss Ueto NCL Wife ao. Tota/ to date ca es Years Sex Colog, or Race (Year Months 4 Single “ da Uf ‘ ¢ Days Married fe49 f a . weelee, Si | His Birth-place Her Birth-place MA csmérery 7 Lot No. Put in the Diagram one mark like this And mark this Burial with double dagger thus Grave No. | for every Grave in it. Section Designate site of monument thus CJ ; hy | Gloves y Bearers or Porters | . ‘ + Hearse tu We dere M22 | =f J CO Removal Coaches /VOOCO Newspaper Notices 709 |0@ | } ay ; t . ~ Transportation Charges ‘ | Officiating Clergyman ‘ ‘ Amount of Bill DR. 4) yl | uo Gee oan. | HU | ceshnaetnenamanstsie asap cies tian ‘a - “ sill snciiblaieaiiibiin | | | | | 4 oe . 1S9S8UEO BY CORNTEE CASKET CO. BOSTON, MASS. 1016 23 RECORD AND BILL OF ITEMS Yearly No. -_ FOR THE FUNERAL OF nett 2 2 b Laie Ke+-+-~ Residence Place of Deat!, Date of Birth O ae (Month) os Date of Death if (Month) (Day) Maiden Name Birth-place Name of Father Maiden Name of Mother... Cause of Death— Primary Certifying Physician Place of Burial Cao Pt Ota Funeral Service at ait Age Feet) Goa Le ye ee Occupation AD—f—f fer Birth-place Secondary ’ a ne oe. Reed ~0r— Residence > fle wh Wife or Widow of f Years Sex Months é ( Days Color or Race Single Married His Birth-place << Leo202 Cn RE Cemetery / Lot No. Put in the Diagram one mark like this a he oe . i as a | for every Grave in it. And mark this Time of Service 2- Ary { + Grave No. Burial with double dagger thus : ¢ P eter I {> ‘a Date of Inte. ment oe Designate site of monument thus: C) Core Casket or Coffin No. tT Aas a Oo¢@° Candles Size Made by Gloves i Lining and Pillow Set No..... Bearers or Porters | | Handles Hearse to e —__-e_ na TR | @|Oc> / | Plate l| Removal | Outside Box or Vault | Coaches AD : Burial Suit . I ree a es je I | Slippers i Newspaper Notices 1 | | Embalming | po Washing and Dressing i | | Shaving i | | | Services | | Use of Chairs | | Transportation Charges Church Charges Officiating Clergyman Cemetery Charges | Amount of Bill =e Music... | Goods Ordered by \| Flowers | Bill Charged to DR. CR. oa ee, 2 Venn / Deve ent ae oe Aor a y _| ie 1SSUEO BY DORNTER CASKET CO. BOSTON, MASS., 1010 238 RECORD AND BILL OF ITEMS oh ; Yearly Wo. ! ] l dA Residence ¥ Place of Death Date of Birth yor = (Month (Day) / QOkerp Name of Father 1p. ve he tT. Maiden Name of Mother Aioie d Date of Death Maiden Name Birth-place Cause of Death. Primary Certifying Physician Place of Burial Funeral Service at es Time of Service / 9 id 4 Date of Interment OV Y, - 4) es Casket or Coffin No. J [asm 4 : Size Made by | Lining and Pillow 2 at No. q a | Handles u Plate a | ( i Outside Box or Vault as | } ; Burial Suit Slippers C i Embalming a Y i Washing and Dressing Cachan Shaving Services Je wey Widow of yy Years 19 VO Age FOR THE FUNERAL, OF (Year) < Q QE0° Candles Gloves Bearers or B6tyer Hearse to 7 bloo +N oO | | | | | | | | | | Her Birth-place ce Secondary ‘ Cemetery ae q Months ¢ Single @ of Ce Occupation .— ip — His Birth-place es Married Tota/ to date Color or Ri ace di Herth AO, S Lot No. Grave No. Section Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : Removal Coaches Newspaper Notices Joo | j j } } Designate site of monument thus: CJ Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music Goods Ordered by Flowers Bill Charged to DR. ; Lo iti ai is (Y @ Na (_|_SO Qeerf heer | Scan |L or bee GG, i 4A ret 1H ~ pCa |_iemieo oe oe na | = | ial ack } an \| = | ij nite wie on | | } i] | - - i| . | . | “3 | J a E: | Mevilaitetienennes et iii ao - _ = | = { | ms ts | ao _ HS | ISSUEO BY DORNTEE CASKET CO, BOSTON, MASS.. 1018 5 Canescety Mag 239 RECORD AND BILL OF ITEMS ly ae FOR THE FUNERAL OF | a Wawa " Setear Der / Natt Yearly No. Tota/ to date Residence Place of Deat!: ‘ Wife or Widow of Date of Birt I — igr? Years {Sex... MM&2a_ Coler ge Base (Month) Day) (Year) 5 Tr Date of Death w— oh 19°%*O Avge Months 4 Single + ‘ f , ee (Month) “) Cn») (eer) i 4 Maiden Name os ; Days Married y @ , ; 4, “Ae Occupation ; Ot C, His Birth-place Aho nL ——— Her Birth-place ns Birth-place Name of Father Maiden Name of Mc Cause of Death—P “<7 V/ Secondary si Certifying Physici AL ie on ee Residenc —- @G A@. “A... Place of Burial Ms fewctt Oh~ _—€! at Funeral Service at Lot No. Put in the Diagram one mark like this . ‘ ¥ N ; 1 for every Grave in it. And mark this Time of Service Grave No. } Burial with double dagger thus : } Designate site of monument thus: Cc) Date of 7 Av gS Section a a Casket or Coffin No... { tobe | ne Candles Size = a y —“—— i ) 2. OO} Gloves | } >» Lining and Pillow Set No..... i Bearers or Porters Handles | Hearse to Plate | Removal Outside Box or Vault | Coaches | i} Burial Suit Slippers } | Newspaper Notices Embalming I Washing and Dressing | Shaving .. | | j | Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill | fee ‘ Music. Goods Ordered wt , i—) Flowers | Bill Charged to ia... CL f lato is CR. — qd 4 bs. Ps Pa Z ne ~ Y | ; . | JO Gece ft kete TN HE Aw tad K> (44 | Wwieo is amines tame Sale of at ‘woes | f_j__]_ "tf }_f Soe | | pl | | te \ r ae 1.4 me | =| =| —— i | } || j i 1} “en | Ce H | ed os | ee -| a ies i | ae = H - i 1| { | | os | | 2 4 | — — a i i | a | ls | | | | | i 4 - - eae ca | Se Sener | sae een a) i om eer ee Pree |---| scheint i Mia ia sisal wil +|- ei lig nae a be : | | | sees : si lama iat ee sisi ilies anesiitidaia os | | iseUgo ey SO., BOSTON. waeS.. rete wil 240 Yearly No. f 1 Residence RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date Place of Death© j . of Ce_2 2 2/ Date of Birth pie = : O_Years [Sex Cglor or Race : j Date of Death ott / IS 1920 Age Months § Single ‘ (Bk 2th Maiden Name f) ' Va Z Ww Days Married Birth-place +: K4_44¢ Occupation KRALe2_— ' Name of Father "" < His Birth-place Maiden Name of Mother f : Her Birth-place Cause of Death— Primary PRB cota \ i Certifying Physician i By bord, i oi haces Halo, AL ex Ke oe Place of Burial CE ¢ .. ebcdecrery “sans — at 4 eke - ™“ Lot No. ee tiie Diagram one ld elias Time of Service A .s Sof Grave No. ‘ be rae igre ge me eaaek One | Date of Interment St OY | al Section Eee | i Designate site of monument thus ? 1 en = ; Casket or Coffin No. Mao) Gig rth Candles | : 4 Size Made by | Gloves | Lining and Pillow Set No. i | Bearers or P re Hk OD, ’ | Handles | | Hearse to Ua thas nen ot ; Plate | Removal 1 Outside Box or Vault Coaches Burial Suit i Slippers Newspaper Notices ia - . me f Embalming | Washing and Dressing i Shaving | Services | | u \| | Use of Chairs {| | Transportation Charges Church Charges | i Officiating Clergyman + il ictoon Cemetery Charges i | Amount of Bill a 4, a Music | Goods Ordered by id ‘t an v ~ Flowers Bill Charged to A = ate TOF v1... : DR ; CR. i => . Teo. Va Qeerck (Leet | /aoo | | | J OCO | | Joe | | + | | | |— : | ; } 1S8UERO BY DORNTER CASKET CO. BOSTON, MASS. 1016 e- Pa abaasenaenne RECORD AND BILL OF ITEMS Yearly No. FOR A FUNERAL OF si * Ow]— A_A_* 4 G ry ? = : Pf Residence f Place of Deat!: \ Wife or Widow of Date of Birth 19 Years Sex (Month) (Day) (Year Date of Death ; 19 Age Months 4 Single Moath) (Day) Year Maiden Name Days Married Birth-place Occupation Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size : Made by Lining and Pillow Set No...... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving ....... Services Use of Chairs His Birth-place Her Birth-place Secondary Residence Cemetery 241 wisest a Color or Race r Lot No. Grave No. a Section Put in the Diagram one mark like this 1 for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate site of monument thus: | Candles Gloves Bearers oy Hearse 0 Newspaper Notices Transportation Charges Porters eer Ke Re move y Rosin Coaches si - Ne By QL. To Gu. 2 ij | i} | i i] } | | (Ar ne | “0 Ane es i Church Charges | Officiating Clergyman Cemetery Charges | | Amount of Bill | | Music........... | | Goods, Ordered by | | af | Flowers : | Bill Charged to ! DR. Cr. y iy = \ ce ee 4 Va op et ec “yeh 27 oa 4 ‘6 | Z2« — : Laine = i SB se sen a 1 | — a j | | | | a ' Ee OE TT IT stannic dldanencidniectennedenr Ean eee i 242 RECORD AND BILL OF ITEMS Church Charges Cemetery Charges Music Flowers Yearly he. ie THE FUNERAL OF Total to date. Residence Place of Death ‘ idow of hex. i Date of Birth 19. th ". Years Sex Co} or Race { Ve’ (Da OF Date of Death Gv HE 19 Age Months 4 Single : (Month) (Day) (Year) , = Maiden Name ‘ 7 Days Married 1 Birth-place CC hee oe ees. j : i Name of Father His Birth-place Maiden Name of Mother ..Her Birth-place Cause of Death— Primary en Certifying ae - esidence Place of Burial @ <> Cemetery Funeral Service at Lot No. But in the Diagram one mark like this Time of Service <w i Grave No. - = ao aping _ mark this : CLV Pe a ey : urial with double dagger thus: j Date of Interment .. Section : a ’ : ] Z Designate site of monument thus CJ Casket or Coffin No. vote Io ©O}| Candles | Size Made by Gloves | | Lining and Pillow Set No. | | Bearers or Porters I Handles ‘ | ole i Hearse to ..... } Plate hc “Sn 7 ¢ \O og Removal Outside Box or Vault Pre gb ©'|\ Coaches Burial Suit / O|00 I Slippers | Newspaper Notices | : at | Embalming : | Washing and Dressing 5‘ i i Sie O | Shaving 1 Services Use of Chairs i Transportation Charges. Officiating — | oar | Amount of Bill Goods Ordered a Bill Charged to 243 RECORD AND BILL OF ITEMS \\0 i < ANU ke aah Con — OF Tota/ to date win We Residence 2 Be aPos An wWife or Widow of Place of Deat!: Me @ / a . Years Sex Date of Birth Ac“e! (Day) (Ye "~ Date of Death Ace) <r 197 9 Months 4 Single (Month) (Day) (Year) a Yearly No. Color or Race s _ Married Ce 7) - Occupation 2 < a Lf BAA! Maiden Name Birth-place Name of Father is Birth-place Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician Residence Place of Burial ® Cemetery @2 —= [1 No 7 Onn Grave No. sa VO Section i Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Funeral Service at Time of Service Date of Interment Designate site of monument thus: a | Candles Size cancneaies Made by i Gloves Overy j | gouge | | ee l rt oO . Y 5b f* te Bearers or Porters Lining and Villow Set No..... Handles ... emt i / ; || Hearse +h ae Re os - Proceigl. | Remoy V aor (a Lew ? Oa S Plate Coaches Outside Box on alt 7 we pa! *= Ceepy beaks | Burial Suit | Newspaper Notices Slippers | aie Embalming .. | | \| || x | | 4; oo | | OO | Washing and Dressi Shaving .....: Services eo | Transportation Charges | 20 2 35 J Officiating Clergyman zoo! Amount of Bill | Goods Ordered by Use of Chairs Church Charges Cemetery Charges Music... | Bill Charged to } Flowers DR. SOC aa | A < a 1] Lo TOCA ~. 1g laze : [-— fe: } il im t | als | 8 C ‘ se i} cet eh | ; ; } i im 4 | { ' ~ ~ a x | } + hake = 19BUEO BY DORNTER CASKET CO.. BOSTON, MASS. 1016 CR. L142 hap /Hgd (ey § Leak % cf LOGE O aan 4 ba | Ls | (eS ee 747 nin — | 4 : 7 | | ot Pomc i oe | eg cc feneg/ Uys DR. r Bs —- i | } | | | | EF e al 19SUEO BY OOANTER CASKET CO. BOSTON, MASS., 1018 11 244 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date \ Yearly No. / Th. Residence fs fat aA Vs, ¥ Sie. f# f if Place of Death Wife or Widow of Date of Birth 19 Years Sex onth (Day) (Year) Date of Death Re ¥ 19 Ce Ages . Months 4 Single H (Month) day) r i Maiden Name \ePie Days Married Birth-place Occupation . { i Name of Father His Birth-place | i Maiden Name of Mother Her Birth-place mi) Cause of Death— Primary i ; Secondary . oe ; Y A «(eee i Certifying Physician Place of Burial Residence Cemetery Lot No. Funeral Service at | for every Grave in it. Time of Service Grave No. Section Date of Interment Color or Ra € Put in the Diagram one mark like this And mark thi Burial with double dagger thus : Designate site of monument thus: [ ] | on ee Casket or Coffin No r aro 7000. Candles Size Made by Gloves | Lining and Pillow Set No | Bearers or Por Hearse to Handles Plate Removal Coaches 00 | Newspaper Notices Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving 6 Services Use of Chairs Transportation Charges Church Charges | Officiating Clergyman Cemetery Charges | | Amount of Bill Ke) Music I Goods Ordered by «/ Aha Bill Charged to /._/ Flowers DR. L 188UEO BY CORNTER CASKET CO, BOSTON, MASE. 1810 ad . RECORD AND BILL OF ITEMS Yearly No. Tota/ to date / i x FOR THE FUNERAL OF luted Cp Ce Bssmhane Na sf fod | of Residence Place of Death ttn — Date of Birth 19 s Years Sex Male Color or Race (Month) (Day) ‘ (Year \ Date of Death Q.¢ 2 ba 19 i Months 4 Single (Month) (Day) (Yee \ , Days | Married 7 1. el Pde ot G Ye Looe Co Maiden Name Tred eeec ss hs La fey pen ee c — aa Birth-place Occupation , a 2 er His Birth-place Her Birth-place Pecondary he heh» Mane. uv f. ma lee ry ns A a Cth Name of Father Maiden Name of Mother Cause of Death ge * Certifying Physician Vf / Place of Burial AV ay tke wee Put in the Diagram one mark like this Funeral Service at Lot No. 7 ea Qtr Gia | for every Grave in it. And mark this Time of Service A | ; j srave No. s Burial with double dagger thus : f Q (2 4) oC 4 ; | Date of Interment 2 e@ , , Section ; A = Designate site of monument thus: C) pe =e = Sees: Te TEetasos see Casket or Coffin No. [© o oO of Candles Size Made by | Gloves Lining and Pillow Set No.. | Bearers o1 — i| Handles earse to / i Plate Removal | Coaches /S | Burial Suit I | Newspayp r Notices Outside Box or Vault Slippers i Embalming Washing and Dressing © | ; : Shaving i\ | | Services } | } j | | j | Use of Chairs ‘I ransportation ( harges | | | | | Officiating Clergyman | Church Charges Cemetery Charges 1 | Amount of Bill Mt Me ‘ Music........ I | Coada Ordered bt tT, a £ co C+ ' | fe 6 C ae a sill Charged to : he SS SeCSR TO ORIG PRAT NAA A NN nN NI Flowers DR. CR. >) Mey o/ed The oe —— =] { - “~ 7 | I | a ISSUED BY DORNTEE CASKET CO, BOSTON, MABS.. 1010 "| ee | ee eemie rae em 246 Base ener rT enn eens ane RECORD AND BILL OF ITEMS FOR JT E FUNERAL OF y Tee. : pa Wife gt Widow of as ] 5° ok Years Sex fLece Color or Race (Month) ] (Year) Leet é 19 O Age [.° . Months Single : ; “e Mon ay) ( “350 . ; BK la Maiden Name ¢ Days Married . BD / y fee a Jecupation. MAcLined™ wr ee ; Of ee A: VO His Birth-place Y~ Le ee @® . A vA vd other Lda N.84 bo lee’ Tota/ to date Yearly No. "h oe, Residence Place of Death Date of Birth Date of Death Birth-place Name of Father Maiden Name of ! , Her Birth-place Cause of Death 2 Yj Secondary as Certifying Physician si A : Of tesidence — Place of Burial Saf rl) Cemetery f Funeral Service at Meg Ade Time of Service 4 ae Date of Interment fle ee er S —vit-S ta No. Grave No. Put in the Diagram one mark like this | for every Grave in it. And mark thi Burial with double dagger thus : t os ee Designate site of monument thus: i ] ..... Section Casket or Coffin No. a J vO 0 ed Candles } r Size Made by 1 Gloves | Lining and Pillow Set No. | Bearers or Porters | Handles Hearse to y face beecr, Ca | /O.00 Plate Removal | Outside Box or Vault Coaches } Burial Suit Slippers Newspaper Notices | Embalming bs | Washing and Dressing v Prufoc hed, IPO } Shaving ae {| | Services i : | } | | Use of Chairs 7 . p | Transportation Charges | Church Charges pase Lace RM sadly 3/00) Officiating Clergyman ? ae Cemetery Charges soem i O | Amount of Bill 1] seo Music | | Goods Ordered by : Flowers | | Bill Charged to a DR. CR. 4 £ 7 voG (Le 2g dF2 We) (2, Bich | se toate 1 FI Fed, ee] | | H a - i 7 | ! i fiom -| . ae eh “| | | ae zi | | | ~ || | | i i 4 ' | i} Pi ais | | i} | ; jae “oe pa or - | | 188UED GY DORNTEE CASKET CO., BOSTON, MASS. 1018 | | - | i} | | | | j ee aaa cD ncn OR RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF Total to date [5s Pat a 4 é + Residence As ad t AK agit KO * Wife o idow of tek ) J » —s v Mey BIY “> Years Sex Place of Deat!: Date of Birth Color or Race y (Month) a (Day) (Year) Date of Death N\A : 19 L& Age ©. Months § Single (Month) (Di (Year) IA Maiden Name FE at 2 ; Days Married L Birth-place IN BAD KA © AL Occupation Name of Father “ His Birth-place Maiden Name of Mother. v Her Birth-place Cause of Death— Primary, , Secondary Certifying Physician, A 7 4% a HOLL. Bo. stesidence « & Vy ww & Sn ttl Cemetery Place of Burial Funeral Service at Lot No. Put in the Diagram one mark like this ae at . ‘ . : | for every Grave in it. And mark this e of Service Grave No. | . lime of Ser , 4 Burial with double dagger thus: { Date of Interment Section : Designate site of monument thus: & ak “- om } LA > Casket or Coffin No. t | Aa » ( ec |U ¢ Candles f' SH6 Size Made by | Gloves i| 7 o \| Lining and Pillow Set No... | | Bearers or Pogters ij 7 i Pe ee | I Handles Hearse to 4 Plate i Removal } | Outside Box or Vault } : Coaches i | Burial Suit eal / t o | pfposs | : | Slippers i Newspaper, Notices : E i! 7 > oO | i Embalming i Eee Oo | i : Washing and Dressing I i] \| Shaving J I ia og Q arf fe Ol | Services I f | Use of Chairs | Gg q (58 | Transportation Charges | Church Charges | ; | Officiating Clergyman ; i| Cemetery Charges | | Amount of Bill | g 4 | ee | Music I] | Goods Ordered by is h Ln AOsFon es, | | e Flowers | Bill Charged to e Vo 5 | DR. J - CR. 4 Lid — - 7 Oe _ oc Ceeek feos Fadl ee Esha VE, eek. Pe ae (2 : 7 “oe | i z i H 248 Yearly No. ot qg@a2t Residence Place of Death COOL Date of Birth |. onth) (Day) ; Date of Death oro 1t A Maiden Name i Birth-place Loe i i Name of Father _ ih Maiden Name of Mother i RECORD AND BILL OF ITEMS OR THE FUNERAL OF Tota/ to date Lar Mir Ao.6 Naee Arlene re Wife or Widow of NF / Years Sex Color or _™ ace 1 O Ag Months 4 Singl Ze A 6° [ anes m6 5 - gh Skgan Z Married Df Days His Birth- iu Pacatent BS te Her Birth-place i Cause of Death— P a i. Secondary | Certifying Physician Residence Cree tee. G / Place of Burial — AL <<. Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this i ‘Tine of Service incon 4 Geun Nas | for every Grave in it. And mark this Sit i re . Burial with double dagger thus : 1 at Date of Interment Me TZ Zz ? .. Section : i Designate site of monument thus: CJ 1 | Hi ' ae ; = = i) Casket or Coffin No. v FL, YS.) Candles Size Made by Gloves i | i Lining and Pillow Set No. Bearers or Porters } | 1] 1 Handles Hearse to | / | / Plate Removal | H i} / Outside Box or Vault Coaches I : Burial Suit | | Slippers Newspaper Notices | i | Embalming | Washing and Dressing i Shaving sec ; Services : Use of Chairs | Transportation Charges | | | | ey Church Charges | Officiating Clergyman | ban : Cemetery Charges Amount of Bill = ome i Music Goods Ordered y Le? / Cel. ls Flowers Bill Charged y 6, ecLen ka ae | f : i ' DR. / CR. 4 / td AD 5 : od ] SY / ( 4 “ ri VYO@e | .Mool| OL hd (ey he CK. Jy om | anceemeese Keer Rc : * —— ne f—f ‘ - ensues am ~ — | ] j | | cs | | ; - i a — : | “ i | | | ! a | _ EEE o nis | i | | ' i | ™ _ solomon H } | ; ai m } / ai | i | | | i —~ | ee iti i | 5 — _—-— i } _ A j } } | | i} | | on - | | er r ai cea _ | ‘ | 2 ) | i i] i cE — | — | | | ee —|- | tee i | " biti : 1 ee | ' | 1SSUED BY DORNTER CASKET CO, BOUTON, Mass. 1918 22 ean UA a nt Rn a cnc wo stcseaiatesi. acenicasneesitatoncselincna anesthe * Cause of Death 249 RECORD AND BILL OF ITEMS Yearly No. iio FL. FOR THE FUNERAL OF af. KOR srar., Austo Residence.. Place of Deat! a | Wife, or Widow of Date of Birth . B81 2Y..Years [Sex “Wats Color pp Race Date of Death Pe 195 Ages &F_.. Months 4 Single CORTE | Maiden Name ee ah ce / 7 ee Married’ Ad Birth-place ‘Vance, lof Name of Father QMlrerareb ee Co AD_o¢ scupation Aan His Birth-place Maiden Name of mothe Le De. Ih Zz. Fo. Her Birth-place Ce Cr Prima Dy, hl MK gfe? as Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No... ~ [daw Size Made by Lining and Pillow Set No... Handles Plate Outside Box or Vaylt - Burial Suit ’ cam Ss... Slippers Embalming Washing and Dressing ise Shaving Services Use of Chairs ibe. ondary t esidence — eee — J Lot No. } Put in the Diagram one mark like this ne | for every Grave in it. And mark this , Burial with double dagger thus: f Section | | Designate site of monument thus: a | Nee 19 [ve Pung i Jo o Cemetery / ¥Y\OO: Candles Gloves | Bearers or Porters ia _ Cee mm. Ss ~S earse ra {/ O\OO aan [Booen, Mic AI | Coaches i Newspaper Notices by ty 8 o Transportation Charges | | | Officiating Church Charges Clergyman j | i Cemetery Char Asso Ao ©} Amount of Bill ? ‘ v A | / Sie © i Music........ Goods Ordered ew UC Maren, eden ) Flowers | Bill Charged to S ose DR. CR. wo eed | t B,C aeonenecemeertd /E¢ oo 1 j | | | | } ) C t | | | | i | J | oe | oe aes —|- . | 16GUEO BY CORNTEE CASKET CO... BOSTON, MASS., 1810 aeons eer a a een Een Yearly No. IS Aan Residence. / Place of Death (¢ Date of Birth Date of Death () (Month) RECORD AND BILL OF ITEMS FOR THE FUNERAL OF fig Bee KK 9 FCRIL , eek. : ae a¢ Merv e<Je, —4— eo cs Wif idow of 19. .. Years Sex ie” 1920 Age Total to date. Color or Race Months 4 Single (Month) (Day) (Year) Maiden Name Days Married Birth-place W%<Loce & “eo ‘iia Mafia’ 7o Y R6V2 Name of Father His Birth-place Maiden Name of Mother ~ Her Birih-place Cause of Death— Primary Secondary Certifying Physician Rives Nina” Place of Burial vemetery Funeral Service at Lot No. Time of Service ae. 16-[2P Put in the Diagram one mark like th | for every Grave in it. And mark this rave No. Grave No Burial with double dagger thus : { Date of Interment .. Section | | Designate site of monument thus: 3 1 | Casket or Coffin No. Candles | | Gloves Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Jse of Chairs Church Charges Cemetery Charges | Bearers or Hearse to 7° K Remova ( senile Newspaper Notices hos Pak. | Transportation Charges | Officiating Clergyman ad ican Amount of Bill Music } Goods Orderedfby DR. oo Lo ay _ SOC? EH q_[4,\ Be e¢ 3S y ye. + - - eee el ett _ | | " a oie | as | ol | sania a ee : en | | ‘ i 4 m0 aed a Be a ii - er wee aa . | | —_—— _ ‘i a 7 a ecneiesiliiesebtenemnetenia | ——— - _ lll. renecetemenacnenne — |] init —— oo _ _ | ISSUEO BY DORNTEE CASKET CO.. BOSTON. MABE. 1010 : | | | ed ik 7 ad a ci | | | ss iio 251 RECORD AND BILL OF ITEMS , FOR THE FUNERAL OF Total to date 5 ¥ (Ok Ce oe ; 1 O Ryfidence A. M eate Pauw ¢ Q<d€._.. Qe Place of Deat!: Le cee 2. —_ Wife fr Widow of Date of Birth Ax 2 -—?- ga? t Years Sex Color or Race (Month) Day) ey (Ze Date of Death 4s HO { Ace -s Months 4 Single (Moat! (Day) a Tt Maiden Name WY, ay mE eg ays~— | Married Birth-place ‘ hao vLer AN Occupation as Thicsoche Oh tie Name of Father an a aa Y . is Birth- a - : Maiden Name of Mother ihe Merak -placé ce Cause of Death—-P a O —- si Secondary i Certifying Physician ia cC, Ofecen Residence Cte “ Cemetery / Ga t_elor_a_ a” o Lot No. | Put in the Diagram one mark like this B Crave No ? for every Grave in it. And mark this Pi. ree } Burial with double dagger thus: t ea j co Section | Date of Interment ‘ Place of Burial Funeral Service at Time of Service Designate site of monument thus: Es La . Casket or Coffin No. Cala Fithsc Size . Made by. ae Candles Gloves Lining and lillow Set No..... | | Bearers or Hearse to Handles Plate Removal ae Outside Box or Vault Coaches Burial Suit Slippers New spay Moti es Embalming | ‘ | : Washing and Dressing } | e i| j Shaving i| } H Services Use of Chairs Transportation Charges Church Charges | Officiating Clergyman Aner Ciietiess I Amount of Bill eee ee | Music....... Goods Ordered by ; | | Flowers Bill Charged to | DR. Cr. Li {#SVUEO BY CORNTEE CASKET CO. BOSTON. MASS... tere Dea ee ager ier nee — en ee a ee eee 252 Yearly No. \ . —R Residence (Mon@) Date of Death Maiden Name (Month Birth-place Name of Father “VAL oe Maiden Name of Mother la ero a, i“ Cause of Death— Primary Certifying Physician Place of Burial Funeral Servic’ Time of Service Date of Interment ok, Casket or Coffin Not WoL 4— Size Made by Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and ena Shaving ss Services Use of Chairs Church Charges Cemetery Charges ECORD AND BILL OF ITEMS OR THE FUNERAL OF / Tota/ to date Pa OviLe La 1920 Age (Day) oe Single as ai Place of } LR [eset tor C4 = of Date of Birth re 872 Years Ep ® Color ps Rack ja Months p Days Her Birth-place ) Secondary Residence ° Ce... Cemetery Lot No. Put in the Diagram one mark like th's { for every Grave in it. And mark this Grave No. . Burial with double « agger thus: ¢ Section Designate site of mo .ument thus: [ ] {9 OO Q. Candles } i Gloves ! | Bearers or — Q : | 7 ie ENS Hearse to ay J Ov) 4 FC JOO Removal Coaches Newspaper Notices ! i} \| i Transportation Charges i 1 1 | Officiating Clergyman 2 ieaesanacia cine Amount of Bill Inne Music ff x Goods Ordered by, ‘¢ ; = ol Flowers Ah Su \ 5 ) Bill Charged to Replovov Les. so Keo DR. “ CR. | Own fluze, | (8S bol Fins | ae (Reet | /8522 Pe | os | | | | cs bd hanks | | ad | | | ae | | | | | | | | | | — — | eRe on } | | | ed ae | oe rs | | = | | | hile +— | : a | | [i | 186UED BY CORNTEE CASKET CO, BOSTON, MASS. 1010 a 253 RECORD AND BILL OF ITEMS ( Tota/ to date Yearly No. FOR THE FUNERAL OF a Lt Led. rg per 19 ha po: Widow of ope Years Residence Place of Dea vr Date of Birth Sex A4Lo__. Color or Race (Month) (Day) (Year) Date of Death Nee was. 1920 (neg Month) (Day p—~ Months Single Days omy or, Occupation oy His Birth-placed? ~2 0 22 ae “So fa fe Maiden Name Marriec Gredeeg Co Nhe Name of Father Gant, Maiden Name of Ae ET rare Primary Birth-place er Birth-place Cause of Death Secondary ‘ Certifying Physician Residence Cemefery Place of Burial Lot No. | Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Funeral Service’at aR Chew Ase i 0 Time of Service Grave No. Date of Interment Section Designate site of monument thus: C) Casket or Coffin No. Garo 790 O!| Candles | Size Made by Gloves } Lining and Pillow Set No....... | | Bearers or iy “ | Handles . || Hearse to aw. (Clo o Plate } | Removal ¢ ae | Outside Box or Vault } | Coaches Burial Suit JV ye¢ | Slippers | Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges | Church Charges | Officiating Clergyman Cemetery Charges | Amount of Bill Goods Ordered by Music... I i Flowers | Bill Charged to DR. CR VO @Q 22 > eee “ 4 , wm) } (odea| dip My Cane Fane] oe Lk Mili ia | ISSUED BY DORNTEE CASKET CO, GOBTON, MAGE., 1010 i Eccl | | | I | | | ii a - | ] - {| | i a ae ’ i | % I oll wun | i } ee er pea | | | i} | enna | << } } eer | = — 4) ; eee ee mn = ae ff en enemas | —||-——-—- — - - ij 1- —— _ _ ee ee ein | | Se ae | a 252 RECORD AND BILL OF ITEMS Yearly No. OR THE FUNERAL OF / Tota/ to date / | Residence... { / Place of Death OV CAA — of 872 Years Date of Birth ana ae f Sex Color gp Race (Mon@) ay ear) Date of Death Are” i>. 1920 Age ja Months 4 Single onan (Month) (Day) (Year) Maiden Name Uf A Days Married Birth-place N<Le 20 Cp Aer hee at tee Peed haa Maiden Name of a, ee By *% Her Birth-place Cause of Death— Primary ‘ Secondary Certifying Physician Residence © Place of Burial Cemetery Sue aaa ae Funeral Servic Lot No. Put in the Diagram one mark like this | for every Grave in it. And mark th Grave No. Burial with double dagger thus : ¢ Time of Service Date of Interment d LR ~ ae <- 32e ... Section Casket or Coffin Not, Woe) Designate site of monument thus: [30° Q)!| Candles Size Made by | || Gloves Lining and Pillow Set No. | Bearers or ——_ ) : Handles } Hearse to ... Rey Convo 4 POO O Plate } Removal } Outside Box or Vault Coaches Burial Suit Newspaper Notices Koserogenng | 4 oXe)| } Embalming \| | Washing and ren i 7 i! Shaving sy Slippers Services \ ; Use of Chairs | | Transportation Charges } Church Charges | Officiating na) Cemetery Charges | Amount of Bill Music / om i| | Goods Ordered by) ‘nett, Ov Lex = Bill Charged to Flowers ; | DR. a CR. (OB (Lire | (85 00) doe sb 7, (Reek | VES OQ f ; | : am - 4 - | _ | | —_——| 4 ct 8 Se ee a | ! | a Bis on i - . } | | ' cS | . | . || | 1 ery | | Td oe 1SSUEO CY CORNTEE CASKET CO.. BOBTON, MASS. 1016 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Cae Residence - Rew a fear Place of De: ev 4 us r Widow of Beet kee Siu 19 Beas Ciais (Month) (Year) Yearly No. Ara C2 Yo Aativs Sex PIA Breen Date of Birth (Day) - oe ho ry 4 Bn ip Months ae : iaiden Name Days Marrie Birth-place Orgde2e Co “Ti Occupation Name of Father rand, pees — His Birth- rlaccdeRQ 22 & 2 Maiden Name of OE 6 Poser fer Birth-place .* Cause of Death—-Primary Secondary ks Certifying Physician Residence Cem Place of Burial Tota/ to date oO? Color or Race [Soret Burial Suit Funeral Service’at 3 Row. CW eb Lot No. | Put in the Diagram one mark like this piccolo Time of Service Grave No 1 for every Grave in it. And mark this ra Burial with double dagger thus : ¢ Date of Interment & ht a 0 Section ’ : r Designate site of monument thus: ae { Casket or Coffin No... tharos 75 O!| Candles ij | EO roe Made by | || Gloves Lining and Pillow Set No..... i | Bearers or Porters Handles || Hearse to | loleo Plate } Removal | | Outside Box or Vault | | Coaches J[Yyoou) | Slippers | Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs | Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Ag Music... Goods Ordered by / | | -— Flowers Bill Charged to DR. aren | | | | | } : a >| dhe bes ML, Casck 7 sseciialesneniideiiiabdlien | | | | i} HH] i {| - _| e —— = | | oe pisos | | me eo ee Arwsete_ $l, Y7 poo | . ISSUES GY DORNTER CASKET CO, BOSTON, MASS.. 1016 253 254 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date Yearly No. Residence Place of Death Wife or Widow of Date of Birth eee ee 19... Years Sex Color or Race Date of Death 19 Age Months § Single (Month) (Day) (Year) , Maiden Name Days Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place ' bi Secondary Cause of Death — Primary —— ; Pe . : | Certifying Physician Residence | . . i Place of Burial Cemetery iW Funeral Service at Lot No. , P Put in the Diagram one mark like this ie at Sarin Gide No. | for every Grave in it. And mark this Burial with double dagger thus Date of Interment ... Section : | 7 oe Designate site of monument thus: I ] ; A TT gia imine | Casket or Coffin No. Candles | | { Size Made by | Gloves | Lining and Pillow Set No Bearers or Porters | Handles Hearse to .......... Plate Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing once aenreayacetanneunensaananraseneneaenareslwtesa? tenses eenteoamante en — y cs a See a ae ree Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman at Cemetery Charges Music Flowers | Bill Charged to ed Amount of Bill ee ce 4 Goods Ordered by DR. CR. 1SBUEO BY CORNTEE CASKET CO. BOSTON, MASS. 1918 RECORD AND BIL‘ OF ITEMS ae THE FUNERAL OF Yearly No. Residence Place of Death ff a Date of Birth {Oo eae (Month) (Day) (y ear) Date of Death 19 Maiden Name Birth-place Name of Father ——. Coeve— Maiden Name of ay O's r Cause of Death va oh Certifying Physici Wh Place of Burial Funeral Se rvice at : j hee Time of Service 3o/w7d ao f oer Date of Interment Ace sa Wife or Widow of 4s Years : Months 4 Single | 4. Days | Occupation His Birth-place Her Birth-place Secondary Sex fete sale Zoo Tota/ to date 187 Color or Race Kg) : Married hf eJ ts a ae 7 Uh (£228 a ‘i ec indad, Lot No. Section Grave No. 4 | | Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: C) Casket or Coffin No. i ce hay Too Od! Size Made by Lining and Pillow Set No.. | Handles | Plate ue Outside Box or Vault nay CMD recs VI Burial Suit eo Slippers Embalming | Washing and Dressing I Shaving Services Use of Chairs Church Charges Cemetery Charges Music. Flowers on) Candles Gloves Bearers or Porters Hearse to Removal Coaches OO) Newspaper Notices | | | i i | | i j | Transportation Charges | Officiating Clergyman Amount of Bill Goods Ordered b Bill ¢ charged to Batt | | | | MEO . + ior Pr nme Se | | | | | | | —_ i i - | 4 | } | : Coe | : | oe | z | oo farce ® =e al ; Se ee eee | eT ISSUED BY DORNTER CASKET CO. SOSTON, MAGS.. 1018 q i 256 Yearly No. AVU La ~~ : nt pec Residence Place of Death 2 ev 1‘ lent) (Day) , dts ! Date of Birth Date of Death Month y Day) Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death Pringgry Certifying Physic a Place of Burial | SMA Funeral Service at Wh rn ne ee ne AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date Wife or Widow of Sex Aiaeo- 19% sf Wave Color or Race (Year) 19% [ Age: — Single 4 eq hhh, (Year) Days Married a YW iO shai "Re sidenc e QL ‘VE iis His Birth-place Her Birth-place ¢ e Secondary Lot No. Put in the Diagram one mark |ike this Timm of Service \ ; ) Gente No. Se foes — “> And mark this | Date of Interment tRe. +f iA | Section : a | - Designate site of monument thus: oom | . ei fips me ek oe | Casket or Coffin No. t Gav —71\\ §0iO°C | Candles | i Size Made by Gloves | Hi Lining and Pillow Set No. | Bearers or Porters | Handles Hearse to | Plate Removal | Outside Box or Vault Coaches } Burial Suit } Slippers | Newspaper Notices | 4 Embalming | Washing and Dressing | Shaving | | a a Services | Use of Chairs Transportation Charges ie Church Charges Officiating Clergyman on ' : Cemetery Charges Amount of Bill hy ( t SI ee es EONS Music | Goods Ordered by lf Pry Ze f} FE Flowers Bill Charged to : x Aq Vian-|, | . Dr. CR. ; — _| | Jo Gene Jie t 0.00 =. = -——— 188UEO BY DORNTEE CASKET CC . BOSTON, MASS. 1918 a “ RECORD AND BILL OF ITEMS FOR THE FUNERAL OF re: eet es fArbesh. Wife or Widow of Yearly No. Tota/ to date Residence Place of Deat) 257 “et Date of Birth 19 f Years Sex Color or Race Month) (Day) (Year) | : Date of Death 19 Age 4 Months § Single (Month) (Day) (Year) | Maiden Name Days Married Birth-place Occupation Name of Father His Birth-place Maiden Name of Mother Her Birth-place Cause of Death— Primary Secondary Certifying Physician Residence Place of Burial Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this - ie sae ae | for every Grave in it. And mark this Time of Service Somave Mo. j Burial with double dagger thus : f Date of Interment Section r Designate site of monument thus: e Casket or Coffin No... Candles } "i Size : Made by Gloves | | i} Lining and Pillow Set No..... Bearers —.. -- | ar Handles Hearse to G22 0 / CO Plate i} | Removal I an _r/ 12 (Loco Outside Box or Vault Coaches se | | 7 aise A | Keajs > surial Suit | N x , ae Slippers | Newspaper Noticés & | | | <a Embalming | ane » ) Washing and Dressing z or f-Y | /] peek } / | Shaving / Services Use of Chairs | Transportation Charges | Church Charges | Officiating Clergyman | Cemetery Charges | | Amount of Bill ) | / canal Music... l Goods Ordered by Flowers } Bill Charged to DR. CR. sieiaenenienasimeeniane a 2 me | || | | | =| | 1 | \ ia pointe | i I | se \ ff | | mF i} or i } | ij i] | | | -| | | ij || | i ! | | ee = | | | | i | | } a | | | csi lice | ba 4 | | ISSUED BY CORNTEE CASKET CO. BOSTON, MAGS., Tete ame Sees H ] ; a | 258 RECORD AND BILL OF ITEMS Yearly No. aa = FOR THE FUNERAL OF Total to date Adtence ©. hiclhot./ £/3v $0r Co. & (WWE NY Lin i( } Residence i KALA en own J (eA. 2. . Place of Death Wife or Widow of Date of Birth 19 : Years [ Sex Color t a hey) Ye <O1OT OF Race Date of Deaiin cey K> = 19 / Age Months 4 Single “g (Month (Day) (Yer) Maiden Name Days Married Birth-place Occupation Name of Father oO His Birth-place Maiden Name of Mother Corr,, . Her Birth-place Cause of Death-— Primary ~~... Secondary Certifying Physician Residence Place of Burial Lo Cemetery Funeral Service at N : Lot No. Put in the Diagram one mark like this Winn of Gaevice ae | for every Grave in it. And mark this Grave No. ) i Burial with double dagger thu Date of Interment Section — Designate site of monument thus: [ ] cen mene — snaunniinnaeeenenes ™ i r Casket or Coffin No Candles Size Made by || Gloves I I] Lining and Pillow Set No | Bearers or np Handles | Hearse to Plate | Removal / Outside Box or Vault Coaches Burial Suit | Slippers | Newspaper Notices 1 Embalming i | ‘a Washing and Dressing \| | i| Shaving | Services U “— T Jse of Chairs | Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill | — Music Goods Of ye ed by | ‘ YN, ty - ‘ Flowers Bill C ener to // f YUuA } Ae Ae aioe i ba) Mel a DR. ee CR. 1 aoe | a ceo f Loe VOpe | Afi aL 7 [? he wk i Seco —— ; <<} } ~| ‘ a j \—— + - | i | | | ad |-—|- —| bl | | ce | | || - | | “| | i} | i i | i] | | I | | | | | ai i i aia | } | 1 on { i 1 | / |- | — oo ISSUED BY DORNTEE CASKET CO, BOSTON. MaBs. 10186 a RECORD AND BILL OF ITEMS <** Yearly No. R THE FU AL OF BLE 4. Residence Place of Deat!: Date of Birth Date of Death at Maiden Name Birth-place Maiden Name of Motker Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size plait Made by Lining and Pillow Set No.. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing (Day) ft (Day) Name of Father Bee 7 me wdep Ne oe -y! v 7 wZ_2o Ss eee - TY ai 19 v < (Year re / hater " Opgppation Years _ Married irth-place Her Birth-place Secondary Residence Cemetery a Ke cy Lot No. Grave No. Section perineal J Oo 2 Candles Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices so 259 £ Total to date — 7 c2 of Color or Race JPR R<L2022 Ce Rae. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: C) i | Shaving i i Services | Use of Chairs I] Transportation Charges Church Charges | | Officiating Clergyman | he if Cemetery Charges | Amount of Bill Music...... | Goods Ordered by Flowers Bill Charged to ! DR. CR. Ly <i, Ne _ ~ we ” = | a a | # - hd . "a = ‘i €.2 Fh } if * ~ || _ anemia 1 us — =~ bie’ ee crete - ~ ] a - 1 1 | i] | all | me | | | —| | 7 — | | | 1| " } if } | | i i — i ) | ij — i | | Z| | | | t = , |— i | -_ j 1} { | - | | | bon iH | } { | — { . -— —_ fs | | al 7 nil nt i lies j ad ; “a es i ; Sere eee a H | ses ‘ sinleilneen ini ail ai yo witiiiadacie siteiaiicidmaiaam ~s 198UEO BY CORNTEE CASKET CO. BOSTON, wage. eee ie ih sh : “a RECORD AND BILL OF ITEMS Yearly No. Me Rf FOR THE FUNERAL OF Residence OLD, vO oo dE x e. : Place of Death ite ih aici a w of a Ay a ane— ¥ Date of Birth CG IWS (Month) (Day) (Year) RECORD AND BILL OF ITEMS a Total to date Tota/ to date FOR THE FUNERAL OF fag G hes Sine, Plits de a “Mectlof fatge L@ Yearly No. Residence < Place of Deat! ‘idow of abs ae Years atin ears Color or Ri we Hate of Bith Color or Race F j onth) (De StS, hate of Dea eed, “ ay) See 7 “Months gana 7 Date of Death — ; / “2. wae a Months [se 7 < Maiden Name oh “bets / = D : ; f (Month) a. nas ss mpeied Maiden Name Days | start Birth-place Birth-place Co * me . ee Name of Father ae ae tee. on Maiden Name of Mother cae Karyr— GLOGS Occupation 7 | His Birth-plac Ca an, all Her Birth- ‘place e 4 His Birth-place Detesce & e/ Her Birth-place Name of Father Maiden Name of Mother ae CNET, ‘2. ‘ Cause of Death Prime ee <, , : Secondary Bigs Ae leg Cause of Death —Primay Secondary Certifying ee, K2Le- ? “Residence COC 0, ree es Certifying Physiel am - C Shokan — Residence = Piece at Sai 5 : Place of Burial Blow ed Cocee < Cin. Cemetery ' es Funeral Service at : Lot No. Put in the Diagram one mark like this Funeral! Service &f Lew AX . ' Ch ot No. | Put in the Diagram one mark like this Time of Service ff i. Lf Grave No. I for every Grave in it. And mark this aes ok Mice Z / it Ne this Date of Interment YL kta / 2d LS Section Burial with double dagger thu Designate site of monument thi Casket or Coffin No =e /Yooao. fk Candles I Size Made 1 ry | | 1 Gloves ; Size Made by Gloves | oa 2 4G 2 75 Lining and Pillow Set No. 1 Bearers "he orte ‘ ae 7 cae || (Korea CS Lining and Pillow Set No Bearers or Pogters Oe, 1D. 1} ‘i £ o aay | xe, i Handles Hearse to ae ; Hearse to BLavedG Kaas ef . Ys 6 | tor “y J ie ttiea Handles Plate Remova 45" l st has Plate ] Removal CG. o | = OCe in 2 - \| | a Outside Box or Vault Coaches y N 22/2 ql (ye Outside Box or Vault .‘~ i 4Q2 Qe Coaches f/ : Oy-5 © 4S - | | Burial Suit Nyon, oD ho JO Oo | Burial Suit | i : Slippers Newspaper Notices / 2 ~*~ Slip | 3 | Newspaper Notices a p pe rs | j TA4LAA LY nh \ i} Embalming a, 0.9 * 72 Py/ a 2g g 22) OO ibalming V 8 e ef. i Washing and Dressing / | A pe afid, Nabe Ceo | Shaving Shaving —& mn - | eee ee aa ye $e 2 os~— services | services } Use of Chairs i} Transportation Charges Use of Chairs i | Transportation Charges Church Charges i | Officiating Clergyman Church Charges ] | Officiating Clergyman inggiiinenn | . “Sa | | , LS GNIS Cemetery Charges | Amount of Bill ? vy ee Cemetery Charges | i Amount of Bill ~ Sins - fs i ; . | | Goods Ordered by“ CO « 2 nth Music Goods Ordered by Music....... . i " Flowers Bill Charged to Flowers I! | Bill Charged to , | Bee CR. DR. DR. /) F oad i ee } D : —@ eee f. Vic 2. iP Vv Fr) fj Fee yy ] Je Me hak. i 2+ Dy “ : | FWIGOD AQeg sy >/ : Le ee 4 5 Ly TL, 4 | nr "le, aes Ee. | If a | 7 | Ae Ch | As voc | we I = d eat aaoF : ee 1 cde = ae | l Se | a Se | | | | J a i 7 ‘Sapeee = -| | oe | | | | ij ‘“ || | i} ~ \| | | | Bad | a : 5 oT I | J | | } .. | i | | | | | 1} ; yes | a] i a | | } | / e | H a | a | | | a | | wisi : eae 4 —_ | ieee i sical | i | Dein oe sil a | j i i I “ — | eet | SS =: ‘tlie acc on . snaiceas ll istoiaiideiaiehel amber i | sci icine] aneasecininageniaill a i nial in a | } j a | ee Date of Interment Va ( sye/2y Grave No. , Section | | | } | Designate site of monument thus: Cc) © we Casket or Coffin Wa ale <— 7” ee Od Candles 188UEO BY CORNTER CASKET CO. BOSTON, ore 262 Yearly No. Residence J tthe. tel, Place of Death Date of Birth git zn RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date Ms Ww a_kes Wife or Widow of i 1¥9/ “ee Years sex a ee-tize Color or Race (Month) Da car ) Date of Death set vo 927 Age 4. Months Single Lp kof 67 ie : Maiden Name Mth Heel 4 a AS | Pr, £ Da Married wg | ” | Birth-place Sete ; axe - Occupation Ss Name of Father ecle His Birth-place oes Maiden Name of Mother a r 9 Her Birth-place C42 fr, Go ne q = i Cause of Death—" Primz "A, Secondary Certifying Physician av "th C2 re BALES bocitnce Cle, i Place of Burial - hh ca sl Cemetery | Funeral Service at Lot No. Put in the Diagram one mark like this i Wika af Garvin JO g#£ wee ee I for every Grave in it. And rk this i Date of Interment y Vaasa q 3/ .. Section Se i J - / cr Designate site of monument thus ~] H a ad if Casket or Coffn N Yo * = FGEaT Fee, eC0- Candles | Size Made by Gloves | Lining and Pillow Set No. Bearers or Porgérs | Handles Hearse to“ 2 OSA _ VewecVoe, ~ 4 a) OO Plate Rial. free < emova katsng er | Outside Box or Vault Coaches Burial Suit he. ef ( oc Caf 2 oO {Oo Oo ah ‘ | at Slippers Newspaper Notices i : 4 Embalming } Washing and Dressing Shaving | Services Use of Chairs Transportation Charges 4 Church Charges | Officiating Clergyman | di, f Cemetery Charges | | Amount of Bill [1-9 ': Music Goods Ordered by Yeo “ ea siete, AR h Flowers Bill Charged to . o | eek a JevGoe whs WS (KOK L— CR WR MCL Ee Foy Cheah © Daye | os 00 [ee oy | 7, 2O , Fe VE gl, fs 0 WTO ach e ce “ GAG Joo eye a 3 _ om 3! ; ios ,Y /\0 3 | | Pt | SES ee | | | ! 1SOVEO BY DORNTER CASKET CO, BOSTON, MASS.. 1816 263 RECORD AND BILL OF ITEMS y/ Total to date FOR THE FUNERAL OF CE, Vaitttiltles x Cgb.2 2 > Residence. / “4 LAs a nw = ; Place of a VIA ce af ae ence £44. 4_~ Wife or Widow of Date of Birth oa &Z {wv : 19 / G Yearly No. Years Sex Agile Coler or Race } , (Month) (Day) (Year) ff . Cheery Ld 1I9 fA sy Months 4 Single fed: Eketr— Month) / } (Day) (Yes) ee — egies . & . @ Pia L Days Married oa ‘Occupation ~ Sea gay . ‘) . a « a he Rene ssa His Birth-place (“eo fae ha es rae eo. fr , Date of Death Maiden Name Birth-place Name of Father Rus Maiden Name of Mother. Cause of Death— Primar Certifying Physician “AC eo. : Cemetéry / Place of Burial Funeral Service at E Lot No. Put in the Diagram one mark like this ses Sage f Cr N | for every Grave in it. And mark this Time of Service hg r amen tree Burial with double dagger thus : f ts ate > > } / sec » Date of Interment $4 / / OU section | Designate site of monument thus: a | i i a ve ea Casket or Coffin No. Chshe 4 ae @ Candles Size Made by Gloves Bearers or Porters Lining and Pillow Set No. Handles | Hearse to Plate | Removal Outside Box or Vault i Coaches - “ i ’ =4| Burial Suit Vv Le || at 9 « A Slippers Newspaper Notices | Embalming | Washing and Dressing Shaving Services Use of Chairs Transportation Charges | Officiating Clergyman | Amount of Bill Cz | | « Goods Ordered by RI | d, Bill ¢ harg red ty Leo’, ” Church Charges Cemetery Charges Music Flowers DR. Z ; ‘i a f if, | Weak eee O00 ‘dome Wi ) a4 het . a 1S8UEO GY DORNTEE eonnny o>. Boston, - | | 1 | i i are Wo is ee | | | j cg | | | | | l | : | _ | | | | | | 4 | | | | Ed | | | t | od i a Se : 7 | | | , y | | | | ; | i sistabiiniliatn om hile il ~ | ee | ena ane me -~ memes | some ree sth atte rent 1 oe eich eenuiee a | F | a te wAee enemies diacetate aera ela eee Cn ena ene Se ne nn ener 264 G RECORD AND BILL OF ITEMS Yearly No. ‘ < B4te wen C a kth o~ atlice idow of / “om es 19 ae és . Years FOR THE FUNERAL OF Total to date Ca Residence Place of Death “WM e00 si Sex : ) (Month) (Dey) ee a Ye . = 7 Lo at Age Months ¢ Single . Days Married oY Se. a Op < “K “0 Occupation ies don His Birth-place a? = mag Ge — 4 1 Her Birth-place ee Date of Birth Color or Race Date of Death } Maiden Name Sd cf : Birth-place pmon Name of Father Maiden Name of Mother Cause of Death— Prim Secondary Certifying Physicj4n) } Place of Burial | Lot No. Funeral Service at Q a Put in the Diagram one mark like this | for every Grave in it. And mark this Grave No. gi Burial with double dagger thu Time of Service Date of Interment Section Designate site of monument t! c ( wasket or Cc soffin No. ¥ ( a ee : Candles 1| | ral Size Made by ' Gloves = Lining and Pillow Set No. Bearers or Porte Handles Plate | Removal Hearse to Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving i| Services ; peat : ‘ Use of Chairs Transportation Charges Church Charges Officiating Clergyman Amount of Bill Goods Ordered by f Cemetery Charges Music i | Flowers Bill Charged to DR. Wo ) Q@ der fh 1SSUEO BY CORNTEE CASKET CO, BOSTON, MASS. 1018 nnn tattoo " -_ 7S RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Yearly No. dA Tota/ to date / Cc Residence Place of Death ys Db le- Months 4 Single YD or Race Wt Sex Date of Birth tine Sa, (Month) Date of Death nae Moat Maiden Name Days |, Married Mich aus 4 Birth-place Name of Father C Maiden Name of Mother Cause of Death— Primar, Certifying Physician Cemetery Place of Burial Lot No. | Put in the Diagram one mark like this | for every Grave in it. And mark this 4 Burial with double dagger thus : t Pa 17 [vy [ Section | Casket or Coffin ee S / Wane Size ; Made by | Gloves Funeral Service at Time of Service Grave No. Date of Interment Designate site of monument thus: _— Candles Bearers or Port ve 7 i Burial Suit | | i Newspaper Notices Lining and Pillow Set No.. Handles | i Hearse to Plate i Removal Outside Box or Vault Coaches Slippers Embalming } Washing and Dressing | Shaving | | Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music Goods Ordered by Bill Charged to Flowers i ae l C) AYP he 4p Cee Le | CN | Mhy iA a eo 4 — . | iy | ee ; | ‘| SF fe aoe. | ee SEES | | / | | | L | Se | mn } | j | ; “ | | | a ae | ee | | | i ! | i | echt 196UEO BY CORNTER CASKET CO, BOSTON, MASS.. tO18 Sa erp a geen mst atta, SS 266 RECORD AND BILL OF ITEMS Yearly No. / f Residence Place of Death V0. a" (Day) Date of Birth (Month Date of Death Maiden Name Oxaof i, Maiden Name of Mother Birth-place hapten 8 - Name of Fat rer Fedo Cause of Death—-P -* Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Size Made by | Gloves i it Lining and Pillow “Oy I | Bearers or Porters + 1 Handles VaoroY AO Hearse to Hl Plate Grease % Removal { | Outside Box or Vaul Coaches i Burial Suit : | Slippers | Embalming j Washing and Dressing 3S [02 FOR THE FUNERAL OF of Pegy her Cldnpeeh. ee hy | Candles Total to date ife or Widow of Years Se Months Days Color or Race Eas 1 + O, VO 5 Single Married <— upation i ie Stl sie lace BlOL6 Bebe pncicAc e Secondary ie ee Put in the Diagram one mark like this | for every Grave in it. And mark thi ‘ave No. apapie Burial with double dagger thu .. Section r Designate site of monument th [ ] —~* Sjoo/ «| Newspaper Notices Shaving \ / Li | Services { es ‘ / ee 4 : on KY \ Use of Chairs lransportation Charges J x 4 | % i IWS \ ! Church Charges Officiating Clergyman \ J \ fy + lise “4 7% Cemetery Charges) | Amount of Bill a Av Ade ieiensoiacscoaiiasieel | } : t Music Goods Ordered by ( WWJ 7 Ye ; Flowers | Bill Charged to eel ee ee DR. We a a 4 | | | | | | | a - | 1 | i | I wa | { - oe | - I _ 1} ~ | i} ee 1 — - | | | Se ae Se a a 7 —_—-—— —" sate Oo ~ | -- - — ee | ) | | | 196UEO BY DORNTER CASKET CO., BOSTON, MABE. 1010 RECORD AND BILL OF ITEMS Yearly No. Residence Place of Deat!: Date of Birth (Mooth (Dey Date of Death Moath) (Day Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death—- Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size Made by Lining and Villow Set No..... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs han oP he 267 iV FOR THE FUNERAL OF Tota/ to date / Wife or Widow of iy Years Sex Color or Race (Year 19 : Age Months 4 Single Days Married Occupation His Birth-place Her Birth-place Secondary Residence Cemetery Lot No. Put in the Diagram one mark like this : | for every Grave in it. And mark this Grave No. | 5 Burial with double dagger thus : ¢ section ‘ ‘ | Designate site of monument thus Cc) Candles Gloves Th sto “QR 2 2 2 Bearers or Pop | | Hearse to yal d oache My ase Ne wspaper Notices Y © Y@ | Transportation Charges Church Charges i | Officiating Clergyman si | | | | | ae Cemetery Charges i} | Amount of Bill ‘ } : : he Se AA re Music... | Goods Ordered by th WHE, ' : ! Flowers Bill Charged to } | DR. CR. . wom Sa AE Ma ans wah T 7 ee a ; i di 2 2-21, VO Groot Zee 2 APBIO. WJ) Jaa, Caatr aD \Ne | | | _| | | re | I | | ai i | : id | | ] aiid | | | } sail an | Lo | | 1 | | ee | | : | , | ; | comes = , | i ISSUED BY OCORNTERE CAGKET CO, BOSTON, Mase... 1016 \ 268 RECORD AND BILL OF ITEMS Yearly Wo. / 3 , doe 4F (Month zf Maiden Name , Residence Place of Death Date of Birth Date of Death Birth-place Name of Father Maiden Name of Mother Primary Certifying Physician Dn gy, .. Place of Burial Co. Ker Funeral Service at Conan Time of Service Cause of Death 4M GL Mes ak. — (~~ 74 Date of Interment thom i xs — Le FOR THE FUNERAL OF Total to date - Wife or Widow of 9 Years Sex Color or Race / Months § Single Soa fp Y Days Married { Occupation oo eee His Birth-place Dice Corre, 5 Her Birth-place .* " Secondary _ Residence bia Lng». 002 4 A ‘ - ~ ....Cemetery —_ Lot No. Put in the Diagram one mark like thi | for every Grave in it. And mark this ! Grave No. Sar Burial with double dagger thus Section Casket or Coffin No Size Made by Lining and Pillow Set No. Handles Plate Outside Bex or Vault r , Burial $ { Poe fngs i, Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers | DR. 4 (|x aunt, BER | | | == sears IF SO canter | | Gloves i i i } Bearers or Porters i pS | Hearse to i | {| | Removal | } | . | ‘oaches 17 | Newspaper Notices | i| | } | | is ices + | Transportation Charges ' Officiating Clergyman } Amount of Bill 4 Goods Ordered by Bill Charged to | i| | | | i | | — er Designate site of monument thus: ie sliiaiiinan | | sa ) 199UBO BY CORNTEE CASKET CO, BOSTON, Mase. 1816 RECORD AND BILL OF ITEMS Yearly No. Prf ont ula a. do 4 Lat Residence Place of Deat': IR Loewy dias Wy FOR THE FUNERAL OF Tota/ to date Gh of On (hres Ww ? i £ = si Wife or Widow of A De , : i Date of Birth oA 1 ¥ iy ? Years Sex Color or Race (Month ) (Year Date of Death Oe 1972 f Age Months Single ¥ (Menth) 7 Jay) Year) >» > Maiden Name Vt . Days Married f A V : 2 “U4 oO Birth-place Name of Father Occupation A sche & 6 His Birth-place «Lo 2g Cs ne . Vv _ ‘ - Maiden Name of Mother../. “9-4 4-44 $er Birth-place Cause of Death Primary fh Secondary a . ome ae Ws A mt i oe 7 Certifying Physician MY “ tl ; aa Kesidenee Ck. 7 ~ fr ‘ a , ’ - Place of Burial (/. ‘ owe BARD A WY “Cemetery / Funeral Service at Lot No. Put in the Diagram one mark like this ‘Tian ot Gaviinn eave Ma { for every Grave in it. And mark this j Burial with double dagger thus: t Ve Date ¢ >rment rp Sectior ate of Inte n } a Designate site of monument thus: es 77 , 7 - os Casket or Coffin No... |. °-? N Candles Size Made by Gloves Lining and Pillow Set No.. Handles Plate Outside Box or Vault Burial Suit i | Slippers } Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Chargés Music Flowers Bearers or Porters Hearse to Removal Coaches Ne wspaper Notices Transportation Charges DR | Officiating Clergyman rome i | Amount of Bill | ci Goods Ordered by | i | Bill Charged to CR. d IDA, [oe (a seater ¥ ld | [| 18OUEO BY DOANTER CASKET CO, BOSTON, MASS.. 1910 i CY] t y a 270 “RECORD AND BILL OF ITEMS Yearly No. (5 or Five. FUNERAL OF N\Q4qc Residence Mra, 9-40. “ag Ae: .. Pot Es Wife or Wrtowat. C ¢ a2 Years Se - (hk aon ear pam (Bay) aly yee Color or Race q Months 4§ Single pee x 1 Tame Days Married INR kh a Z ie ae Co Rew = Pee, | ma MA_< ase (a5 Name of Father - AV DWN: 4-8. hired His Birth-place ag pe 7, ©: ‘YY ee Maiden Name of Mother Wfo-r rec (ie2 atti ‘W B-f 2Her-Brrth-place (re -H0 20 @» v ae Tota/ to date Ay (on, Place of Death Date of Birth Date of Death Maiden Name 4} (/ Birth-place Cause of Death— Primary / Secondary Certifying Physician ) Residence : ie Po — Place of Burial KA a KD oo 7 2 Catferery— Service i / A / - ee J Funeral Service at eet Lot No. Put in the Diagram one mark like this Time of Service roy - 1A. 24 Grave No. I for © very Grave in it. And mark th : 20) i Burial with double dagger thus Date of Interment 7 <<... f ‘ f f 2 Section i : 7 Desig: ate site of monument thus: CJ wait / ie Casket or Coffin No. i } < ¥ / +S 2 @) Candles Size Made by ea || Gloves | Lining and Pillow Set No. ! “| Bearers or Porters | Handles Hearse to , qx Ae ne ee AR GX a , | £Qi\c / i ; ry. Fs j id | Plate | Removal} Y2444.—2A 446g 9% Bay oh Outside Box or Vault Coaches/ vA vet 8 0 fa RX. i ‘et Burial Suit aes $ 8 vw OC < ft¢ { frx JQ bs Kf | ic c Slippers : fy S - 1}© ©} Ne -wspaper ak Z4 Embalming | f | Washing and Dressing | Shaving | Services I Use of Chairs Transportation Charges Church Charges Officiating Clergyman es aS a Cemetery Charges | Amount of Bill ‘ ‘t7 =, Music | |_| Goods Ordered by $2 ~- Ke 2S | Flowers | | Bill Charged to dy te ie DR. | ISSUED BY CORNTEE CASKET CO., BOSTON, MASS. 1018 NER nastiness RECORD AND BILL OF ITEMS . FOR THE NERAL sch - ft BA 24 _Q____— / Wife or Widow of Pact ~S iS 4i Je Years Sex 74 Ohe— (Moath, (Day) (Year Wl Age Months 4 Single Date of Death An th) (Day) es t (Year) gs Maiden Name i a4)... AAO a UWiAte, 3 34,, ia Married fad Tota/ to date AG Yearly No. Residence Place of Deat!: ree Date of Birth Color o Race Birth-place Fh Aaa . / < 2 - V _Seecpption - MRA RA NM fe Name of Father Ys " ih So A Go A veer His birth-place y rs 02. Se ewe Maiden Name of/Mother : : A OV t XZ , Ladd Her Birth-place fi i he Cause of Death—Primary Secondary Certifying Physician ../ ' } Residence JV F A ‘ i-(*. Place of Burial JY Us» CA _o » / Cemetery ee 1 . rs farNo. Put in the Diagram one mark like this 1 for every Grave in it. And mark this Burial with double dagger thus : ¢ et ro ryy . Grave No J Oe ay : ) TK mS 4 Section | Designate site of monument thus: a | gene awe arene Funeral Service at LAA! a Pi ; J Time of Service Date of Interment Casket or Coffin No... Candles Gloves Size Made by.. Bearers or Porters | | Lining and lillow Set No... Hea se to Handles Plate Removal i} Outside Box or Vault j | Coaches Burial Suit kv Qid/, | a 5a!) | e Slippers | Newspaper Notices “& / [@ Embalming 4 oH a 4 Washing and Dressing | Shaving I - tA - | y Services on Use of Chairs H Transportation Charges Church Charges | Officiating Clergyman Amount of Bill | | | Cemetery Charges Goods Ordered by ( Music.. i | Flowers | | Bill Charged to DR. CR. F ~ ee ca sseniiten — Ia —| Z f iY { A f met - £ + 4 i i: g r a CC | A erm is LA i | eno 1S6UEO BY DORNTEE CASKET CO.. BOSTON, MABR, 1916 | 271 site > enn ETRE RIT 0 eer er meer sence etnnnetiemee ete etna tne aetna ~ re newrmmraaee = eemneteenreeacnnnpe nr seagrasses ee enn te a RECORD AND BILL OF ITEMS FOR THE FUNERAL OF = Tota/ to date Residence Wife or Widow of 1 Years { Sex Jars | Place of said | Color or Race At pA D2 Date of Birth sath) (Dey) (Year) : e of De : &. ; e oO Mc a § Single gz Date of Death F< at e... 19 +/ Ay / Month ee Y.- J CORT /*Y Days Married Maiden Name - = ? AL c Occupation Fey ALhi-f~ Name of Father < ile f+ Giadsyii, Birth-place Cte 2s, @ A @ Maiden Name of Méthe I Fhe = ea Pr A_£. >€AL Her Birth-place Secondary 2 © Birth-place (l/ee “a o Cause of Death Primary Certifying Physician Residence MN ae Ja eer beets! Resa Ce ce LAist CEA. Lot No. Funeral Service at Time of Service Grave No. Date of Interment ¥ [Pr / Section ores nr Sent “ | 2S 0o Candles eh Place of Burial Put in the Diagram one mark like th { for every Grave in it, And mark ¢ Burial with double dagger thus Designate site of monument thus [ ] Se ramsonean mam Gaaket or | offin No v ( BAL Size Made by | | Gleves i Lining and Pillow Set No | Bearers or Porters fo ot Handles Hearse to YAMA U jw F | Plate Removal | Outside Box or Vault - Coaches Burial Suit Pr Ce Qs, are ¥ oo Newspaper Notices | Slippers , Embalming ‘I | Vv acs: 4. sett eS Loo | P Washing and Dressing Shaving Services Transportation Charges | | | | | Officiating Clergyman | a | 3 oo Amount of Bill a a Ae Use of Chairs Chureh Charges Cemetery Charges Music Goods Ordered ely 6 Flowers Bill ¢ alee to 7€ DR. : ’» ( vA 7 | ASKET CO, BOSTON, MAGS. Fete Fe sdvnsnniniinsesnit ee sce ENCN tet RECORD AND BILL OF ITEMS Yearly No. FOR THE FUNERAL OF i fasek AS te ay re ‘or j M, 8.07 ed ER a, AG : Residence Tota/ to date 43 | Place of Deakletge (“ee ala <2r.— Wife pr Widow of : Beceponte ; , 3 t 927 { y Years x hae, Color or Race Date of Death ae ey. x ne A | é sie |S ee BRE, ae | Maiden Name f day Married Birth-place } Jy 4 a . ‘ r nw & Occupation = wiry a Name of Father A ao. His Birth-place Che BS - fe Maiden Name of Mother. 1 | nf Me K Cv nACE Ler tininplace r on 8 Cause of Death — Primary i “or =" Secondary d senna . an >) I Certifying Physician vo. V 7a? ¢ e Restdence AZ 7 lLoev@ A e f Place of Burial : Ae 2.O-v © OVC L Ce A - Cemetery Funeral Service at . Lot No | Put in the Dingram ene mark like thia fime of Service = Grave No, itera es nk Man | Vir fo i P | j Date of Interment Lee me / 7 Section Sistine tie of eae oO } Casket oteeothre a, eh po — 5 JMO Caniles | Size Made by j Gloves ining and Pillow Set No | Rearers or Porters Handles | Hearse to ] Plate | | Removal | | Outside Box or Vault Coaches | Burial Suit Slippers Newspaper Notices | Embalming | | Washing and Dressing | | Shaving | | Services | . Use of Chairs | Transportation Charges Church Charges | Officiating Clergyman . ke Cemetery Charges Amount of Hill < F We : Music Goods Ordered by Flowers Kill Charged to DR. CR. nee es ee oe pemmemee »- a —_e qquywines Ts Oe a Jo <4 | x lV oO Ee, y 24 ( o sip r —_ | | Sal i} | a | l | | | | | | | + | | : 1 | | hol = <n] {| | | } } i Lisstih | 19OVUEO BY OCORNTER CARKET CO. BORTON, MAGS, 1018 RECORD Place a Death; ai he of Birtlf Maiden dia Birth-place Name of Father Maiden Name of Mother Cause of Death ly Hal. B- Primary ¥/ Certifying Physician ai AE 4 seh Place of Burial AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date. i f of “ho Years Sex Wrage Color or Race (Year) / a 194 Age Months 4 Single ote, (Year) Gan bate Days oe i Janbiove © ic = His Birth-place Her Birth-place or mea Residence Ct Cemetery 4, pat ~ Funeral Service at ~ Lot No. : . pad oe Put in the Diagram one mark like thi Tiss of Service Grace No: I for every Grave in it. And mark th Burial with double dagger thus : Date of Interment “ . Section... Desi f CO esignate site of monument thus ] Candles i Casket or Coffin A She Qa. Size Made b th | / ae pe A-~ Sher 2 | Lining and Pillow 5 o. i Handles } Plate b Outside Box or yyy Burial Suit Howe + Qe ddor s+ Slippers Embalming Washing and Dressing Shaving Services i Use of Chairs Church Charges Cemetery Charges Music | Flowers I| Hh DR. { i " Meer £ heen — $$ - ~ | | i i 2 | Gloves Bearers or Pgrters , Hearse to do pot ap . Removal Naser. Coaches Newspaper Notices | OO Transportation Charges | Officiating Clergyman | Amount of nee Goods Orde } Bill Charge At, BY DORNTRE CASKET CO, BOSTON. MASS. 1016 RECORD AND BILL OF ITEMS Yearly No. a 7 FOR THE FUNERAL OF Kf +. ‘Vif A L ch é4 A 2 Residence £ vy — Wife or Widow of. kh 2 “Years Place of Death Date of Birth (Day) (Year Date of Death / 192 Age Months (Day) (Year) — Days Married Occupation hi LAEP Maiden Name es J “- <. Birth-place yg ke EL Name of Father ti, His Birth-place BLOG a_ Maiden Name of Mother. ker — Her Birth-place fe Secondary . Cause of Death Primar Certifying Physician ay Place of Burial a Lee kee 280 Residence ; Chet-OL- Cemetery . ae. ee. we A, Single An fek a LER ede. Total to date. oe Color or Race He ChraseL— @ “we : rr Funeral Service at Lot No. Time of Service {/ o elect CLELL Grave No. Date oc Interment FES, /6/ vf Section Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ¢ Designate si.e of monument thus: C) Candles Casket or Cofft,, No... Mae Wale 15000 Made by | ke Size Gloves Lining and Pillow Set No... Handles Hearse to Plate Coaches Outside Box or Vault Noodle ei ‘e Burial Suit | va (OC « QS 4 aos | immo Slippers | . | Newspaper Notices Y Embalming i| i O?g Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Offic lating ¢ lergyman Cemetery Charges Amount of Bill Music | Goods Ordered by . i} Flowers Bill Charged to ze ft ray Bearers or Porte all BeyOePe i ne ohevere’ \ Removal 4 foee. Henne @ OA 4 @\00 | | pring! PS OC (aul, Frewns Sf J\co DR. in , Woacnt leeee 2L foo | a 19GUEO BY DORNTEE CASKET CO. BOSTON, P¥$ec Mek] (Ie, (Re 276 f Yearly Wo. “V1 Residence Place of Dean (2. J A Date of Death Maiden Name Birth-place Name of Fi... -r Maiden Name of Mother a Cause of Death— Prirpary Certifying Physiciar Place of Burial / - ae. 3 We Funeral Service at Time of Service Date of Interment Date of Birth 19 3 (Month) 24. (Yea a 1924 Age mth) a4. (Year) Years Days ek Cemetery Qe Sex Rite Months i [ Mar Lot No. Grave No. Section RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date. r or Race Put in the Diagram one mark like this | for every Grave in it. Burial with double dagger thus : And mark this Designate site of monument thus: [ ] Casket or Coffin Nov (Kabon Size Made by oe . Lining and Pillow Set No. | Handles Plate Outside Box or Vault Burial Suit wae Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges I} Cemetery Charges Ti Candles Gloves Y || Bearers or Porters | Hearse to Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill ; ‘ | Music Goods Ordered by | | | r | | ; Flowers Bill Charged to | DR. CR. "4 | | ] f \ ~ paul bo aaorte 4 , } Ts \| — VS - = ; as a 1 wal | isin eeeo rs ES | | Ee = . C4 ee ai \| Sa | | i ae lf | | wel eniinelins ~ ie | | | | 1 ; ; i | | ieee | ‘ 4 _ : 1} — ~ | 4 aid | sani iain ‘ gl ie i | ae — ISSUED BY CORNTEE CASKET CO. BOSTON, MASS. 1918 ee a RECORD AND BILL OF ITEMS i hee FOR TH® FUNERAL OF Nits Te Yearly No. lu Residence A Place of = iy, Ler Wife or/Widow of a ore Date of Birth ey wi } .. Years (Day) ar Date of Death oe ~ 19 2 Age Months ne Yer ° (Mvntlf) y) ( “$900 | Married Maiden Name cf. X\ Birth-place hi OF pe. @ , a - Name of Father. 7". ° tahensg le @4.His Birth- place Maiden Name of oan C Rake CC. Yer Birth- place fe 277 _ Total to date Color or i | Cause of Death—-Prim AF copdary Certifying Physician ne, a Residence i Place of nouthaceceh 5 ete gC tery : : Funeral Service at Lot.No. * | Put in the Diagram one mark like this i is = P atl ; | for every Grave in it. And mark this ‘ Time of Service BVO, t s ‘ 9 Grave No. , Burial with double dagger thus : ¢ i Date of Interment 7 section | | Designate site of monument thus: | | t Casket or Coffin Gusev f Ocodo Candles Size / Made by Gloves 4 Lining and Pillow Set No..... | Bearers or Pogters Handles | | Hearse to : Plate } | Removal, 7Ve2_, F Outside Box or Vault i Coaches” Burial Suit | BSloo Slippers | Newspaper Notices Embalming | YN. oOo | Washing and Dressing | | Shaving | 4 Services | | Transportation Charges Use of Chairs Church Charges Officiating Clergyman Cemetery Charges Amount of Bill Music...... sess I Goods Ordered by Fiowers Bill Charged to DR. 3 a e So ee ; | , | 188UED BY DORNTEE CASKET CO, BOSTON. MASE,, 1910 aoe 278 a Soar peice ts Sains RECORD AND BILL OF ITEMS Yearly No. FOR, THE FUNERAL OF lia Oo A yl Lee at Place of Death ne Wife or Widow of Sex Color or tet e Date of Birth iGos wit Years fry b) Day) (Year) Date of Death Mek ; 1997. Age . QO Months Single (Mont (Day) (Year) Maiden Name iB Q au. Married Total to date... Birth-place “ eng Name of Father Lay hatte. His a Maiden Name of Mother (24.2) Her Birth-place = ; : ; Cause of Death oe } RR. . ? : Certifying Physician , Place of Burial M/ . Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this I for every Grave in it. And mark this Burial with double dagger thus: 1 : Designate site of monument thus: CJ] Time of Service Grave No. Date of Interment lA Oh . i .. Section Candles OO} Gloves | Bearers or Porters Lining and Pillow Set N6. Handles | Hearse to Plate 5 Remova a a gs es 0 Outside Box or Vault Coaches 4 ~ Burial Suit | YVGOO “ingot conk t5 tt) 24 armbar. B. @. Slippers ewspaper ee 1:10 Embalming : F$\oo | Payage ty , o Sypot— Washing and Dressing Lt | Bae » 1 Go | ite: Gem : ; ee Service 2s Rerseoerinng VPhatfes | ! o o ° e I Use of Chairs i] Transportation Charges i | } wane eee Church Charges al at ‘: O| Officiating Clergyman pie shar : PISFES 0 } Amount of Bill Music Flowers rae A z my | Bill Charged to A ee a a i| | ws | fo ede = at el | : ae 186UEO BY CORNTEE CASKET Co. Yearly No. Residence Place of Deat!: Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of M Primary at faite Secondary Certifying Physician ‘sidence Cause of Death Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. Size Lining and Pillow Set No...... Handles Plate Outside Box or Vault Burial Suit 279 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date Bil Pits 1 QGuiar.de Ogo Acvr.2 2 Cr - t Wife oy Widow of q & iO Ys ( 76 Years oft tenis Le ‘EL a 19 2 Age 4 a Months Singl¢ (27 (Month) (Day) Year) ~" Days _ Married ALC’ Occupation Reece verescol fost Sa Bess € 22 Hie Birt »place A. Color or Race . lhe | le Ae G irth-place te a Cemetery Bae. ied ag fred liar BD A1pnPb_— Grave No. ae / al Section me) Candles | | Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: ¢ Designate site of monument thus: C) Made by i} | Gloves Bearers or Porters | i| | | ; | | Hearse to - Cercle, I /o oa | Removal [bee ex, Ck } Jlo o Coaches WA Coan I / 6 oo | Plas Varahh Canary Ss er. Slippers | fico | q Embalming I Jive Washing and Dressing | Jloo Shaving ..... a | Cane wz, Og a : Ao o Services | } 184 14a" Use of Chairs i aad Tre _— ation Charges £ Church Charges iH | Officiating Clergyman : ee | G t Ch | Amount of Bill — Jo Cemetery Charges i Y alain Music I Goods Ordered b ARK Qlouke 4 i i te cesety (hh, tte hae. | Bill Charged to Flowers DR. —4—4|]— I 198UED BY CORNTEE COSKET 0., eoeron, MASS. 1016 280 4) , Yearly - - ; Residence Place of Death Date of Birth (Day) Date of Death a Maiden Name i Birth-place Name of Father © We Acusselk - Ope Maiden Name 6f Mother Cause of Death Primary Certifying - OM era C3 st = cl éA. ot Place of Burial Funeral Service at Time of Service Date of Interment Casket or Coffin No. ee Made by Size Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving | Services | Use of Chairs Church Charges Cemetery Charges Music Flowers Rg Poadoan, l) ys My 060 wines: eeu SH. ete RQ (0) AREER ode Day) « sie Pus Re, J ieee on Lot No. Vd FOR THE FUNERAL. OF Wife or Widow of . 19 Woins US a of 7 7 — Sex . —— sr, a4. Days Married Occupation hehe: His Birth-place Her Birth-place Secondary — ( ‘emot€ry Grave No. Section i 4 RECORD AND BILL OF ITEMS Total to date “Color or Race Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thu Designate site of monument thus: | ’ nal l Od0'1O g Candles Gloves Bearers or P. Hearse to Removal ri eee / ‘om LO 8 o Transportation Charges Officiating Clergyman a i. Amount of Bill lar oe i Goods Ordered } | | oods Ordered by o Bill Charged to f- ep Newspapy¥ Nofices ? “Lecsanng Pos: Plases baer SOO ] | | | {O00 Ge © me a hee ee eet 13 Sloe 19OVEO BY CORNTER CASKET CO, BOBTONM, MAGE.. 1018 Yearly No. Residence Place of Death Date of Birth Date of Death Maiden Name mks Birth-place : Name of Father Maiden Name of Mother Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment ae GA hee RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Total to date hata G € oh ee a. “¢ Wife or Widow of 281 76 We? ] 7 Years io Color or Race ‘oy 24. 19 2/ Ave & Months 4 Single : CLL, _ et on £4? ae Days | Married“ Matsy Occupation ve a OK His Birth-place é Aly Aée Her Birth-place ‘Gm etval . @Q. ; ep ae 5 eR vile Da Len Ae as ek | Grave No. , | Ae enemy: Yo | for every Grave in it Ere Section r Put in the Diagram one mark like this And mark this Burial with double dagger thus: } Designate site of monument thus: a | Casket or Coffin No. Size Ma Lining and l’illow Set No Handles Plate Outside Box or Vault Burial Suit Slippers embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery ¢ stharges Music........ Flowers l i Tore Fett Candles le by Gloves Bearers " Hearse to | | Removal 7 | | | ln Lacy rans rth ate heey | Os Notice of | Coaches = 4 haa | 1 | | | | | } | Transportation ¢ charges | Officiating Clergyman Amount of Bill Goods Ordered by || | | | | Bil ania 5 I2 Co oo DR. V7 Te Chow | Ht | sila - 7 | SO @ewt-/ Jee o, a Hoo Yl, fy Are, Seth he i MU Lot W allantoid na K usYo MM <H | ) SS ae gt . e — f VY La leeks | | | i 282 RECORD AND BILL OF ITEMS Yearly No. “7 FOR THE FUNERAL OF Residence : au a AL 2) Place of Death Yiatizi Dee Te Wife pt Widow of P fh mnt ” 64 j Years Sex Vr2ee-~ tM ~~ uy 19H. Age Months 4 Single (Moath) (Day) (Year) Ee Manin Tota/ to date Date of Birth Date of Death Days Married Maiden Name Birth-place Name of Father Maiden Name of Mother Cause of Death— Primary Certifying Physician . esidenc Place of Burial Ui perieerChe et feeble Funeral Service at Lot No. . Time of Service Grave No. Date of Interment —- WI f Section : Color or Race (Cit is Birth-place atau ¢ | | Ae Pat in the Diagram one mark like this I fer every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: [ ] Casket or Coffin No. UT (@. Root “OO OOo | Candles - | Size Gloves Lining and Pillow Set No. | Bearers or Porters Handles | Hearse to .. Plate | Removal Outside Box or Vault Coaches | Burial Suit V0.0 0 | Slippers Newspaper Notices Embalming ecker HMO Avo Washing and Dressing | ae Oth Iw? | Shaving | | Services Use of Chairs Transportation Charges Church Charges | Officiating Clergyman Cemetery Charges Amount of Bill CH Music | Goods Ordered by Flowers Bill Charged Grovarhred” Ry Gok O CL ex DR. S Art / Daw Mie om a7 Q L pepton VE a +r7Jloo | UA ee® Nite My Thee thea | a j | ee 1S8UEO CY DOANTRE CABKET CO. BOSTON, Maes. 1910 283 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Residence Vici ie cc get 7 (ater, Place of Deat!s . A. Wile a. Ge Date of Birth tY issn 3. iS SV f 7 Years Sex (Mont (Day) ar Date of Death Mh ber Ch wT” (Month) (Day) Tota/ to date. ? x Yearly No. Color or Race 19° 4 Med se Months 45 Single Jd, (Year) Maiden Name ~ ia Jk aa ae . “Le, GS Ae NE. Occupation QK2e4., — His Birth-place *r Birth-place Birth-place Name of Father Maiden Name of Mother Cause of Death— Prima Secondary : Certifying Physician, Cle Place of Burial . Funeral Service f Put in the Diagram one mark like this igus pie j , | for every Grave in it. And mark this lime of Service Grave No Ducied with double damm ties ( Date of Interment fff Section eckesnane sihn of mciicbaaas tial ry Yo Casket or Coffin No. LAC 7 = OFF. On cae Size aes Made by j Gloves Lining and Pillow Set No... | | Bearers or Porters Hamndbes cc || Hearse to eeceee | S200 Plate Removal : | j | ¥ Outside Box or Vault i || Coaches eh. J i . x. : 66 i | | 1 i] | Newspaper Notices Slippers i] Le | | IB? « J Embalming Burial Suit Washing and Dressing, 7 | iy he THe a ze, ' Shaving Aa 7, J\e 4 Servic | Services \| tt { Use of Chairs I | Transportation Charges ne C | Officiating Clergyme Church Charges | | ficiating Clergyman rar — Cemetery Charges I | Amount of Bill ay Music | | Goods Ordered by ‘ BS i| Flowers | Bill Charged to 7 ae "7 seen Y a DR. : : a gis CR. - Z . re - / l } Z ? r ‘ eC oh “ah. f 4, 27 hy ae , 3 rt aie os sae eiiatanaie SS aa i —— c + ¥ + eect Nene ei | Vy]: — | + x] t= i - | J | ‘pace a NO | “| | | ] | 3 1 | —| | ae i HH] | | | } i] | | |} } | ] | | | = | -| 4 oe | H j y i “ \| | i | i | = {| ne i Ps | } : | | | | —— ~ a ; 1j ho _ _ a ~amenneneemeeee aeons sen een - | : Saad ——_ ae .. _ ———____——— ——{| ----—--—}--— _- sp {———~- | | | . cl: = — i soso Sines see ska acne ihentinteisnenlc : | ™" 19@UEO BY DOANTES CASKET CO, BOSTON, MASS, 1010 ~ ce ee. 284 Yearly No. } Residence Te FUNERAL OF Place of Death Wife or Widow of Date of Birth 7 /G 19° Years Sex A ae Mi ) y) (Year) Date of Death C4 BS 1927 Age ‘Z~ _ Months Single Yew (Month) (Year) RECORD AND BILL OF ITEMS Total to date Color or Race fIay Maiden Name Peteoe Co 7 Days Married Birth-place CLory AL scupation | Name of Father His Birth-place Re ~ Maiden Name of Mother ter Birth-place Cause of Death a nS: A Secondary ¢ Certifying Physiciar b Residence Place of Burial <Leeeo vometery ‘uneral Service ¢ uw y Funeral Service at Y Lot No. | Put in the Diagram one mark like this Time of Service v4 Grave No. | for every Grave in it. And mark ¢/ 2, ae Burial with double dagger thus Date of Interment 27 Section penne Designate site of monument thus: CJ : 4 { ee mae va {| | | Casket or Coffin No. E: aso / z& va Candles \| | | Size Made by | Gloves Bearers or Porters J it iT] { Lining and Pillow Set No. i| Handles ¥ Hearse to ... Plate » 45> Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving Services Use of Chairs Transportation Charges Church Charges Officiating Clergyman Amount of Bill | Bill Charged to Flowers DR. (Ve Quek (ree : | | a I as ae Cemetery Charges | i r ee ? ; | | = | ‘ Music | | | Goods Ordered by << f Cam | | * . : ef « ec | 1SBVUEO BY CORNTER CASKET CO. BOSTON, MAGS. 1016 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF ” , fj? Kecey % [Pedic KR ss 39s Ova Av.anuthR Le _ AL ar2.2c32e — 30 Yearly No. Tota/ to date. “ Residence Place of Deat) Wife or Widow of Date of Birth Qe e 7© 19 ZO . Years Sex Color or Race (pont (Day) (Year) Date of Death & Ch i... 19 AF Ave a Months 4 Single (Month) (Day) (Year) Maiden Name L Days Married aide ie yi. ; z , : > : Birth-place AF een SP Occupation os @ C. AL Yetere @ ALC fhaby Coristzacztn. -2— IY Mtoe. Meceee2-f Vis Birth- place Maiden Name of Mother Mite. 7 Meu ce. Thora An— Her Birth-place Cause of Death— Primary Li rngee Coy ae dary J hoe Certifying Physician “MM A esidence Cemetery Lot No. Grave No. | Name of Father Place of Burial Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: t Funeral Service at Time of Service Date of Interment ACH Lt 27 Section Designate site of monument thus: es yy Casket or Coffin No. Candles Size Made by } Gloves Lining and Pillow Set No..... Bearers a ie TR 4 Handles Hearse cr hi $e Pt To Portiey °0 a : | | Remoy Plate | issue Bye Afte o ae Outside Box or Vault } Coaches | cca Burial Suit Newspaper Notices Slippers Embalming Washing and Dressing | } i} | | Shaving | Services . Use of Chairs | Transportatign Charges Church Charges i Officiating Clergyman - e » 2V \00 Cemetery Charges | Amount of Bill yf, , | | | Viste Kae Music. | Candas Ordered bY” b1hhet./ | | Flowers Bill Charged to DR. CR. VotaeT LL HW po a yg ituda—| Aafioc | ae | | | Seer | - ; meee a SS ae | | a | | | | inshore | t+ 4 | | | | ae | | | | | - | Pa | | | | | in | | | | | | 2 | | | | ; ee a ae Ee are ya | CPE er eater ij ins | wie = a Se 7 ee _ |. ae 286 4\ RECORD AND BILL OF ITEMS | teary... 4 OR THE FUNERAL OF Tota! to date Residence Sa a a ; Place of Death DIVX +~_~_Wife or Widow of Choy aalls Date of Birth ] v oy Years Color or Race Date of Death 1927 Age @ Months ¢ Single t 5 Maiden Name 7: a. OP ILM Married - Birth-place Occupation Maevee ae cet a Name of Father irth-place > Maiden Name of M Nhe A irth-place ‘ Cause of Death- Primary econ se isa ol ures pred. Certifying Physician a Place of Burial : Cemetery a thee «al } 1 Funeral Service at Czy Lot No. Put in the Diagram one mark like this _— hae Grave No Soh PS enter ay te Date of Interment we Ch Section ° ; si | | : i 7 — Designate site of monument thus: CJ | . m | Casket or Coffin No. Candles a i Size Made by Gloves 4 Lining and Pillow Set No. | Bearers or Porters Handles | Hearse to r } Plate | Removal ’ Outside Box or Vault Coac L* J Burial Suit ee Rie a | \ a | Slippers : Newspaper Notices ~ | Embalming USP O Tri ; : Washing and Dressing 2 Shaving ho : “Tao } | Services ee ore t ; | Use of Chairs | Transportation Charges ‘g Church Charges - | Officiating Clergyman . aac Cemetery Charges | Amount of Bill Md 1D O bid Music | Goods Ordered he g-2 Woy “i | Flowers f Bill Charged to Rae Cah ROY Dr. 1SO8URO BY CORNTER CASKET CO, BOSTON, MASS. 1010 RECORD AND BILL OF ITEMS FUDIERAL OF Yearly No. FOR Residence Le eros, Baru / 18 Jhon) ay) Place of Deat! Date of Birth Date of Death Maiden Name ee ae aCe ce [Paw Birth-place Name of Father /. Maiden Name of Mother... Primax A) By. . Cause of Death SY a ~ Occupation _ His Birth-place Nits (2 Widow of Sex Aaley 6 Months 4 Single Sofpeat f Oy Married Predkste & KE Years Her Birth-place Gaia Ose RG pdwodary - Certifying Physigia Residence Place of Burial —— Cg ‘emete Age Funeral Service a = honk | Time of Service 2 3o Grave No. Date of Interment Mek. Y Section oe 1 for every Grave in it. Burial with double dagger thus : ¢ 287 Tota/ to date. 3 av Color, or Race r Put in the Diagram one mark like this And mark this Designate site of monument thus: | x Casket or Coffin ay Restate gs y TID Q.|| Candles <i 7“ J l Size Made by Lining and Pillow Set No..... Handles Plate } Outside Box or Vault | 2obol Burial Suit Core fl 2. UR 2 e pero ety gt ay a SI a / ’ and Dressing WALk oF ee i ext Use of Chairs Slippers Embalming Washing Shaving Services | i | Church Charges |= Gloves Bearers or Po Hearse to 4 Removal AA Dhl co Dasek Vaer2A Bayes | Ne wspaper Notices Transportation Charges | Officiating Clergyman Amount of Bill AZ mina O10 © - O ao Ole . Cemetery Charges / | Music | Goods Ordered by 4 Flowers | Bill Charged to — DR. a Y” CR. ; - > a rT ; ~ r «ff | /o nl alhaahaone eh el hf To ¢ To i /é | = on | / sl i] A , i| ' ee ae Ff Pn Ba are at 288 Yearly No. Residence Date of Death Maiden Name Birth-place Name of Father Maiden Name o Cause of Death Place of Burial Funeral Service at Time of Service Date of Interment Place of Death , Date of Birth ‘7 Certifying Physician other... Primary, bi ..Her Birth-place RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date. = Wo “Ware” Day) (Year : wl Age a Months 4 Single (Day) / (Year) e Days Married Occupation .... ma Att His Birth-place Wet fe, CRE Paur 4, KH ney Widow of .. Years Color or Race iat par Cemetery Lot No. Put in the Diagram one mark like this | for every Grave in it. And mack thi Grave No. ee Burial with double dagger thus : : .. Section... Designate site of monument thus: 4 c Size Lining and Pillow Handles Plate Burial Suit Slippers Embalming Washing and Dress Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers Casket or Coffin BOF af asp Made by Set No. Outside Box or Vault labegernn tt % Be | Soo © || Candles || Gloves Bearers or Porters Hearse to V™ Oy veae,to i i i| i| I (/2Vo Removal Coaches FOO | C_ewy— 7 19 O oF, 4p2 | Newspaper Notices Transportation Charges Officiating Clergyman i } ‘| Amount of Bill a 1] \ | | Goods Ordered Me Borsrom ba \ Bill Charged to | \ tsoumo ey connens CASKET CO. BOSTON, MASS.. 1016 oS ee ee ~ ws ed a EERE + Yearly No. Residence.. Place of Deat!: Date of Birth Date of Death Maiden Name Birth-place Name of Father Certifying Physic) Place of Burial... Funeral Service at Time of Service Date of Interment _Casket or Coffin No. PE Lining and Pillow Set No...... Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dre: — Shaving .. Services Use of Chairs Church Charges Cemetery Charges OS a Flowers DR. ~] a —So@errt¢ ree, 289 RECORD AND BILL OF ITEMS Kt FUNERAL OF geal we <a” Wife or Yidow of - :... Total to date J , a Aietiod ee get 19 Sex Bia Color or Race onth) vw” (Year) , 19 Age Months 4 Single os o 2 Days Mar: ‘ed yes : Co ee Occupation . Te e) At % ~+t OY His Birth-place UVe- (Month) ae tac aca. ath nance a iets w~AL_ Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Lot No. 6 Grave No. VU Section Las Designate site of monument thus: C) Taye, . Candles lYoex. leo O27) Gloves || Bearers or Porters .. Made by.. Hearse to Removal Coaches | Newspaper Notices Transportation Charges ooo Be te ae pea es Officiating Clergyman ccmsenbiionnsaainal sabe Meee Amount of Bill Goods Ordered by Bill Charged to ISSUED BY CORNTEE CASKET CO, F 290 ed Yearly No. ats: Residence... Place of Deail / Date of Birth lonth) (Day) (Year) F Date of Death £2 19.27 Age Months 4 Single (Month) (Day) oY : Maiden Name wi? a Te Days —O Pirth-place LF F- Name of Father . Maiden Name of Mother. Cause of Death— Primary Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Sru > / Casket or Coffin No. Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers wy Washing and Dressing Og a? yr We | Embalming Shaving Services Use of Chairs Church Charges Cemetery Charges Music FOR THE FUNERAL OF 1A VV .. Wife or Widow of .. Years Her Birth-place ................. econdary A Residence Sex Married . A otha, Lh 00 Sy, a His Birth-place CxHaevrha y eo 7 Lot No. Grave No. ... Section || Candles || Gloves Bearers or Porters. Hearse to .. | Removal | Coaches Newspaper Notices | Transportation Charges | Officiating Clergyman '| Amount of Bill e: RECORD AND BILL OF ITEMS Tota/ to date Color or Race’ Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : { Designate site of monumen thus: 7 Gogh Ordored by7O Flowers | Py chars DR. , 7 —_— Z . J J | [went Neer |] vod He'rgy " se nal eS ie oi | ha Z ln a ead ee oa : pe a od al aN crea ie aa = i aaa Sao pte ae ve L Z nine ie - o- oe re oT ? —" a ¢ scilcsiiaid 1 " | : ii i a on ee ee : ag , eae , anit cticaial oe si ier enw sia lacie ia cd BB we oe | ; | sisi weveo BY OORNTRE CASKET CO.. BOSTON, MASD.. 1918 291 RECORD AND BILL OF ITEMS 3¢ Yearly No. 4) FOR THE FUNERAL OF tal to date = ~~ ’ CV ase eeu Miderssel/ Beerered Residence... Voki, wel, a. Oo -_ ~-@€4..4 — Place of Deat) Wife or — of e Date of Birth Sh a a 19 / 6 Years Sex WV BL. Color or Race ib) (Day) | (Year) Date of Death VEL £9 19 27 Age Z Months 4 Single Saw he > (Month) (Day) src) Days Married PU dece_ Se dete Gnae Maiden Name 72 @, | Co ; Te Goiasitin j His Birth-place Her Birth-place Birth-place Name of Father Maiden Name of Mothe Cause of Death—Primary. Secondary Certifying Physici ay Dre Ah artros Residence. oe Place of Burial Cp 22+ ed aie Cemetery Funeral Service at ee ae Lot No. Put in the Diagram one mark like this —Crave No. \ { for every Grave in it. And mark this } Burial with double dagger thus : } Section Designate site of monument thus: es Time of Service Date of Interment Af t ¥ YY / Di. . 52 2D Candles Gloves Casket or ¢ ... Made by Size Bearers or Porters » i} Hearse to - Lining and Pillow Set No.. Handles Plate Removal Outside Box or Vault Coaches Burial Suit Slippers Newspaper Notices Embalming Washing and Dressing Shaving . Services Use of Chairs | Transportation Charges Officiating Clergyman Church Charges eT . Cemetery Charges Amount of Bill ”) é 7 SF og Music........... : Goods Ordered by Aes. Ler ees 5 Flowers ... | Bill Charged to fe ce TEP TS a o Jay -— DR. : Tae BO AL No be “7 Vioo aed wall gat sa me K wie ate | 1 z a * Vico : I | bs | /QO\00 = : | 1 hc 1/ oy 34) f0. ; 4 tessa — + 4 7 | | ae | ed . x se : =a [ik eae iincitiaiag ee Fe si , aa | j I | ade = “ —|— a en | a een om —_—— _ ~~ Scie ed ee ee || _ — “|i aaa eeierernren — — | — c eee a ee ee oe oo — ns <deeemeneinngmenameenes a ~ » . si ISSUED BY GCORNTEE CASKET CO., BORTON, | a idle i ch sie 292 47 ee Yeurly No. Residence. Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother., aa ) (@ (Day) FOR THE FUNERAL OF ae Wife or Widow of : RECORD AND BILL OF ITEMS Total to date. i 19. ho | ... Years {- ; Color or Race (Year) 19.1 Age4 .. Months 4 Singic .. ear) | Days [ Married / Occupation .... ..His Birth-place ...Her Birth-place oe a —. | G He Cause of Death— Primary | Secondary case ea Certifying Physiciar Residence Place of Burial Cemetery Funeral Service at Lot No. Put in the Diagram one mark like this Time of Service . : | for every Grave in it. And mark this ee Grave No Burial with double dagger thus: t Date of Interment a i = Section. [ Designate site of monument thus: CJ ae 1 E lo Casket or Coffin No. a4 i : O12 ©|| Candles tr | \ | Size Made by \| || Gloves 7 \ Lining and Pillow Set No. i | Bearers or opers | ; i | { | Handles || Hearse to = , Plate Removal © a Pi OP Outside Box or Vault Coaches of ON ® | Burial Suit o . || iw ~~ Sa on Seca “lao Slippers Newspaper Notices ry oes Soha ea | Embalming ‘: ‘OAzA4 ve] Washing and Dressin end 09 al , ‘ e a" ee y é Shaving } f+} Ss Saveinas | OR 8 tas Ir ervices | oe t a Use of Chairs I Transportation Charges a Church Charges i Officiating Clergyman aia Cemetery Charges } Amount of Bill L + ICS. Music i | Goods Ordered by Pe i} | Flowers \| Bill Charged to 6 t vale f } - “ 7 ci / ao - DR. Us ihaad. 16 Knee CR. Z A, aa a z thie eee Ql , ee 4 ont ond ities ; wf Leff) oc WOLLRINA_ (LEE | acess io hadi cot : Ree: ener J v / f | : ce . } FA j | —f+ - — } - id | Ht — “| | — —— —| | mse Boe ae eee! _ — wan - ee | _ ——-- — - ——_— -+|—____—_—_ oe shies ‘a a A || ————{_ 4 | — — _ — —— = | a aaa hie —~ to | am = " wa, ISSUED BY CORNTEE CASKET CO, BOSTON, MASS. 1018 — icin RECORD AND BILL OF ITEMS Yearly No. Residence....... Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mother.‘ —K Cause of Death ee. * : /) Certifying Physician...” A. B—~i L we Pow Place of Burial Funeral Service at Time of Service > ae on /, Date of Interment Gfn ’ ‘Yo J. Casket or Coffin No. v/ 952 Size Made by Lining and Pillow Set No... Handles Plate Outside Box or Vault ” - Burial Suit hob. a Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges R THE FUNERAL OF < : £ Lb_2_o-0-t.f/— 7 Wife or Widow of. t a Years of 19 uf Age 7 tuhnrch eb Months Single </2¥ 7S OO ‘candles Gloves Bearers or Portesy Hearse to Removal | / flor | | Coaches | | New spaper Notices S00 | Transportation Charges | Officiating Clergyman | Amount of Bill | Goods Ordered by (Coc eze Ea. / ee eo Tota/ to date Color or Race 77 Days Married 2. “ie / ‘ 7 e Occupation /.. CL see G ie OM <2 AAA Tis Birth-place a & re fuaah Her Birth-place fs er » Secondary t ns e 5 “ : CBeeas/ Residence a oo Ceméter— fot No. Put in the Diagram one mark like this Grave No j for every Grave in it’ And mark this r neue ; Burial with double dagger thus : ¢ Section Designate site of monument thus: ith Music.... Flowers Bill Charged to c? | i “— aa i CR. DR. ak . ss oe fk GP ° _ A reccf ILROLR, //PGP PO 1 ee ees a i Chup Lee. L SY cho Oo} } ‘ | (22S. i 4 : | | J | / | - 4 | i] d F | cs re —_ 1 “| | ~ ssi sal ; | | a | pd -—— aa | - - ere | Te cisepemmanamamnes ee | = i | a — — || ———— — ee - - . aa rere _ een } i] H. |- nccsitniinnnigll nsssncneitilimaiil di Se en ee ee OE eRe eng ween te PE ce Ee ne ener TS Ee eee ere ee ee 294 ee ee ae Yearly No. oY Residence Date of Birth Date of Death Maiden Name Birth-plac Name of Father Nes Place of Death ae RECORD AND BILL OF ITEMS FOR "RE FUNERAL OF lest Maiden Name of Mother. Cause of Death Certifying rape Place of Burial Funeral Service at Time of Service Date of Interment Primary Bilile [Cra aie je Af, vfs Casket or Coffin No. Pitre Haze Size Made by Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming Washing and Dressing Shaving Services Use of Chairs Church Charges r 19 cet a4 (Year) OS WH ey 7 2 o . Occupation .™ His ainatinn'é ...Her Birth-place : vt Secondary Residence Lot No. Grave No. .. Section 20. } | 1} i | | | | | ge metery | Bearersor | Hearse to | Removal vi or Widow-of Years ifn Candles | Gloves Coaches | Newspaper Notices Transportation Charges Officiating Clergyman Total to date _ | Single Color or Race Loos ia ta, OO <6 he rarer de, CO KO JK —e —— Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : t Designate site of monument thus: [ ] AL 1 Soo Cemetery Charges | | Amount of Bill usic I Goods Ordered by F i} } il Flowers I J || Bill Charged to ide DR. ’ fx ye . OU. rk Jo Qrnrtlerre é a _ t - “a = ssilieasebiial | —| jemi _— san — -| Gist nen a. ea an —— neal’ ened inlinneipi | | | a ——|— - sila Scio ii — Sit gil ictdbacrennee screed ila: | as Fick 7 Be a ia | oon eo ae } | ee ; 188UEO BY DORNTEER CABKET CO, BORTON, MASS.. 1618 Yearly No. Residence. Place of Deat': Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Cause of Death Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment Size Lining and Pillow Set No Handles Plate Outside Box or Vault Burial Suit Slippers Embalming... Washing and Dressing Shaving .. Services Use of Chairs Church Charges Cemetery Charges Music... Flowers DR. neg * RECORD AND BILL OF ITEMS (Month) (Month) 14 hohe = $e Casket or Coffin No.) Usage’ esos ae Made by t+ @ RA+4>5 Color or Race Ohete Put in the Diagram one mark like this And mark this ) FQ@R THE FUNERAL OF Tota! to date J Liesl a. ty Nal hc 90 Atul Wife or Widow of ‘ iov! Vears pe A a lo- 1994, Age g Months bana Gud f Days Married Occupation > oad £ es His Birth-place Syhene Ae Her Birth-place ta ; C+ econdary , Residence 2.2. emetery / Lot No. / es { Deciel oth doabts diager ier Section | | i | | | | aa y | | Up | deo Ps —— , | — de \ Candles Gloves Bearers or Porters Hearse to Removal Coaches Newspaper Notices Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by 4 Bill Charged to | jl Sas nr — Sek ISSUED BY DORNTEE CASKET CO, BOSTON, MASS. Designate site of monument thus: Cl] Tes SER seks SAENGER ES Se RN oat me 8 SSRN SO pr eae nese tnt one 296 Yearly No. HfL Veer , 4 a Jesh Place of Death Date of Birth Date of Death Maiden Name Birth-place Name of Father Maiden Name of Mothe Dovgor C14, Cause of Death—P. we Certifying Physician Place of Burial Funeral Service at Time of Service Date of Interment apr i menor: RECORD AND BILL OF ITEMS ce FOR THE FUNERAL OF Wife pr Widow of oa i 6 o f O Years (Da: 944 a Ea 44 Age Months § Single y ea yeh 4 Days Married seMaer’ Total to date. Color or Race a ew | Ra “Oe: SO on oS a se ian G a7 His Birth-p¥ice er Birth-place Se Residence Dk: 0G foarte Cemetery ———fot No. Grave No. Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus : ? Designate site of monument thus: CJ Casket or Coffin No. Ss — Size Lining and Pillow Set No. Handles Plate Outside Box or Vault Burial Suit Slippers Embalming nn and Dressir ie. Services Use of Chairs Candles /| Coaches Jol\leo o| || Newspaper Notices Transportation Charges | Officiating Clergyman Made by » | focal] Gloves Pook, Port || Bearers of Co | Hearse to . ese Church Charges / asian innit Cemetery Charges YY fp Br gqrrns pede Amount of Bill a ee Music / | 3 | Goods Ordered by | Flowers et || Bill Charged to | i | DR. ee CR. 4 | oe Li K CK eek | 2% ce WSOVED BY DORWTRE CAeKET CO, BOSTON, MASS. 1910 Ne Yearly No. 4 : Residence. ee Place of Death ) a Prony sis Date of Birth “ap! We 19 ZO Years it (Year) Date of LDeath : * : 19 of Age // Months ont (Day) (Year) Maiden Name “) Zz Davs Married 7 ‘ Birth-place he eed <o €- Occupation } Name of Fuber.. Maiden Name of Mother: a Ka RLE (de Cause of Death a « igi Funeral Service at | Certifying Physi Place of Burial Time of Service Date of Interment Casket or Coffin No. j Made by | | Size Lining and Pillow Set No... Handles Plate | Outside Box or Vault SS Birth-place Wife or Widow of Her Birth-place . Secondary BA BA ons Single ad So aA Chieu larry Cerfietery \ Lot No. | Grave No. Section ac cy : 4+-Oceo Candles Gloves Bearers or Porters Hearse to Removal Coaches | Zz Burial Suit Leet Dye. 77 i C10 || 1 ft Slippers Ke. eS ae | b 20 Newspaper Notices Embalming i] Washing and Dressing Shaving .. Services Use of Chairs Church Charges Cemetery Charges Music.. Flowers Transportation Charges Officiating Clergyman Amount of Bill Goods Ordered by | Bill Charged to 4 ) A i Ae, Steees hha. J RECORD AND BILL OF ITEMS Py Tota/ to date = FOR THE FUNERAL OF Walla be Aen: ep Mali a te — Color or Race os @ @ ne Put in the Diagram one mark like this | for every Grave in it. And mark this Burial with double dagger thus: ¢ Designate site of monument thus: Cc) DR. es a Meer eevee i J j FOSS Man i ue « meat ji i oo : | | | Mey Cs we 2 2c ame Wa ti 3. ; jer tT / 198UEO BY CORNTES CASKET CO, BOSTON, MASS., 1916 297 — i fi f 64 Residence Place of Death Date of Birth Date of Death Maiden Name (oath) , (Day) ( eer) 19 (Month) RECORD AND BILL OF ITEMS FUNERAL OF Tota! to date__- 167 ¥ ~ Color or Race S flere’ Married tes a3 Single Months Days Birth-place PE esccnnsahe Occupation . ANS i : Name of Father Orn Th His B(Ath-place —« Pi oo Maiden Name of Mother 4 aaa ek one ee - Cause of Death— Primary Sennett 8. Certifying Physician Resid — Place of Burial Funeral Service at . Lot No. | Put in the Diagram one mark like this Time of Service BOTY : Grave No. ( for every Grave in it. And mark chis Burial with double dagger thus : t Date of Interment .. Section Siideaieasi Wik it ntiaiia tren ~ rs Casket or Cofhin No. — . (IN 02 ]| Candles Gen» aes Size Made by | | Gloves Y pre 7 J\e ° Lining and Pillow Set No. | Bearers or Por Handles | | Hearse to ....f.. foro Plate Removal En a Outside Box or Va | Coaches Ces.f Reka. / ajo? Burial Suit Slippers Embalming ult rsh Washing and Dressing Shaving Services Use of Chairs Church Charges Cemetery Charges Music Flowers DR. /{\e2! f Newspaper Notices Avie 2 | : | i | 0 Mh | co | voy ogp 4 ° ° Transportation Charges / 7 | Officiating Clergyman 1 Amount of Bill oowlanithannnnsh ies || Goods Ordered by | Bill Charged to saa : 1S8UEO BY DORNTEE CASKET CO, BOSTON, MASE. 1916 : trad (ibicinnsesiaien 299 RECORD AND BILL OF ITEMS FOR THE FUNERAL OF Tota/ to date. f Vv Yeerly No. Residence Place of Deat!: Date of Birth Months 536 4 Days _ i. sinned £09 Feo 203207 F, Birthytece ME, Oo Maiden Name of Mother Ker ae Cause of Death;—-Primar ee Dy J. V. Goo es... Date of Death Single ~ Maiden Name Birth-place Name of Fat het x in Her Birth-place Secondary Residence Om, _Gemetery Certifying Physician Funeral Service at Place of Burial Lot No Put in the Diagram one mark like this eek ; ; 1 for every Grave in it. And mark this Grave No. | Time of Service 4 Burial with double dagger thus: ¢ Yi : Section er Designate site of monument thus: C) ae = Ford | 274% Date of Interment / ‘LOoOoO Candles Casket or C & 7 4 | | Size fa. Made 1 Jets PS: Gloves ij Lining and Pillow Set No...... v | Bearers or C. - Handles Hearse» oo > / eS OO Plate } Remc 22 Ga | 1 J Outside Box or Vault | COOP O) Coaches a €3.4 @ x/2t: i Roloo Burial Suit Y 00° | | }— Newspaper Notices | 7Sloo| | qeot BSS Slippers Embalming ae Washing and Dressing Shaving .. Services oO CO. Transportation Charges Be Officiating Clergyman Use of Chairs ( Church Charges Cemetery Charges Music... Flowers DR. bay i oy) -| eee eet | on | | . - \ i | | | os | | - I i i} i _ 4 a | | | — | a. } — 1 | | oe my | —— er pee | 4] — ——— —— } 1 i _ —_ - Ti aad i } | | " ee ca — ——| simian <cmiall nctaea | | - = Ms, IRGUEO BY DORNTEE CASKKT CO. BOSTON, MASS., 1010 2 sche mes Babar ree ree earner 7 2 sO i Sere ay On nn ene ene tne Se Ste eee a“ OR THE FUNERAL OF HK, Yearly No. f S 2 Residence Place of Death Date of Birth Date of Death Maiden Name Birth-place Q. Name of Father Maiden Name of Mother hice Cause of Death Paina ftty depecp Certifying Physician 4 . : : Place of Burial q- Wk Cemetery Funeral Service at -— ae 7 en Gis L oa econdary ‘ Lot No. Time of Service Grave No. sf Date of Interment has. JI LZ / iis Section Wife or Widow of a (OK Year (Year , 19 oe | see} ~——-....Months 45 Sing} 2 (tal : (Year) ea U ed Days Occupation : ; rs His Birth-place =. nha Teeg, Heg Birth-plac er erate cele = ~ RECORD AND BILL OF ITEMS Tota/ to date ; 4 Sex x . Color or Race L ~—— te , Put in the Diagram one mark like th ] for every Grave in it. And mark ¢/ Burial with double dagger thus : ' a Designate site of monument thus: [ j Casket or Coffin N e /VWNIE2) Candles | Size Made by Gloves | Lining ““d Pillow Set No Bearers or Porters } Handles Hearse to ! | Plate iy ‘2 y / Removal Outside Box or Vault offig 13 / oO hO O° Coaches Burial Suit Slippers F tS \oo Embalming Washing and Dressing Shaving 8 | 5 J | Services ot & ji Je O Use of Chairs | | | Church Charges V 1 | | Amount of Bill Cemetery Charges Newspaper Notices Officiating Clergyman Goods Ordered by I fhoy os : / | | | Transportation Charges | 1635100 Music Flowers i| Bill Charged to ~ DR. Z ae Wareek/leen, | (630d 4a, sis eames ee ¥ o 3 +) fh } / 7 _ : 75.4. hs p sal | e ar ee 4 | 1 | | | an : ances commana, at {| ' | : I ial iene | sia —_—————} a —— —— — aa | y ; _ etd oe ae ij nae } 1SOVUED BY CORNTEE CASKET CO, BOKTON. MAE. tote State of North Carolina Department of Archives and History Raleigh nere< tion were target sheet(: t is further sheet(s) were insure archival quai they were microfiim lm approved, 4 f f Kf Cte 2 iad nected fam a ( atat amera Opefator