Sample Survey Worksheet ~ Bunker Hill Burying Ground, Charlestown Mass.
Compiled by Charlestown High School Students


Student names:
_________________ and _____________________________

1. Name on tombstone:_______Lydia Louisa Low ______________

2. Male:___________ Female_____X_______

3. Date of birth: ______________________________________

4. Date of death: ____________________________________

5. Age at death: _______________________________________

6. Type of material:

Marble______ Sandstone ______ Slate _________

Granite______ Metal_______

7. Shape of stone: ________________________________________

8. Symbol or design: (Winged Skull, Winged Face, Urn/Willow, Hourglass, Bones/Skeleton, Coffin, Tools) Other____________

9. Condition: Broken, Cracked, Sunken, Tilted, Repaired, Illegible ~ Overall: Good ~ Fair ~ Poor

Epitaph & # B42____________________________________
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