HomeMy WebLinkAboutCemBK1901to1907pg1-0011a
FA
i
RECORD OP FUNERAL.
Date ...... -__.-._.____.
the Deceased__._ �fk_11
ante of (/
-
ltar$e to--
rder given byFpric,
—.
casket Coffin
how secured _ ---- - -- -
of or . .
Metallic Lining . .
late of Funeral_._..._—_.__ ----
" Outside Box
'uneral Services at __...__..__
Grave Vault . . . . .
'ime of Funeral Services .......- _........... .....
" Burial Robe
_.
Burial Slippers and Hose
EmbalmingBody(with ....... ._.._-.._....._.._..Fk
•, 6 physician —___._._..___..___._._.__.._._....__. ___
11
washing and Dressing .
,cpttfytny
Shaving .
Vumber of Burial Certifleate_...._v ___ .-••._.--
<
• Keeping Body on Ice .
-� < e
;cure of DeatTt �- �•......- � �`•-�•-•�-•�-�•�•--�
•-�-- Disinfecting Rooms
late of DeatTt _--___._
Use of Catafalque and Drapery
" Folding Chairs . . .
)ecupation of the Deceased. � rr r'_
Candelabrum ,
/
>ingle or
Candles
46ed ....................... Years . .................... Jllonths, .......... ._.__Days. Gloves . . . . . . . .Crape .
3ody to be shipped to - --
Number of Carriages .._........_......... _ @$............
5ize and Style of Casket or Coffin...__.__ —._._
__
Hearse . . . . • • • • •
Wagon Deliveries .................... _.�--.--_.._._._.......
Death Notices in._.......... .... .-Newspapers .
— ----
lfanufactured by ---
(NamesaINewspapers)
Aretallic Lining_ ---
-
Flowers . • • • • • • '
Outlay for Lot • • . .
Outside Box _
—
Opening Grave .
Interment at_..__..... CdX � a&__Cemetery-
Lining Grave .
Lot or Grave No. .. Section No•_..._y=-
Shipping Charges, prepaid
Removal Charges -
'-'" "
Cremation Charges .
•l.
_ __.
S. ............_._...._...
-.....___ ____,.........._
Total Footing of Bill
... _......_......._...._>.1.._ :..:...
_
By Amount Pa.d in Advance
(Ulagram of Lot.) Balance
Designate all Graves in Lot with numbers (1, 2, 3, 4) etc.), and mark
61,ace for this Funeral with a cross (+)•
Designate place for Monument with a small square (G)• erPage_...._...._....., or below.
Use space to the right of Diagram for the names of those buried in Lot. Entered into Ledger, __
19
!G
C
_...............__..................................
__—..-.`..._.. -T tr 1900.
Coruplled by F.
J, FEINEhfAN, St. Louts, %,,, It, tile y