HomeMy WebLinkAboutCemBK1901to1907pg110,111-0068r
0� FUNERALS
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No.�J
h"anre of the Deceased
charge
lrarg 2
Order liven by--���
How secured_—�
Date of Funeral�at �
Funeral Services
Funeral Services
Time of
Clergyntaa
Physician_ -
Cerlifying _.
Number of Burial Certift, e'-'-- - - --
Cause of DeatJL__`J
p
Date of Death
Occupation of the ee t Religion
sed
Single or carried_
9ik-
,Aged—.ist---Y'ears, —__--
Months, _ Days -
Body to be shipped to
Size and Style of Casket or Coij'Ln—_--------
Manufactured by_ —
Metallic Lining
Outside BoxInterment at --
—Cemetery.
at Cemetery.
Lo1or6rav8AL__. ___...._SectionNo. _
1.
'L.
RECORD OF FUNERAL.
No
``— -- the Deceased..__ ..
''��, Narrce of rJ
) Casket or Coffin Charge —
nee of I
" Metallic Lining Order 5 p
Outside Box How secured --pp— -
Grave Vault f Funeral _z1a'�L�
• Date o ` _.__.-------
Burial Robe _
Services at -- a.. -�+�_
io Burial Slippers and Hose Funeral
Tuner l SGTULCP.S[.�
FmbalmingBody(with......................................... bTu(d� TLnte of
Washing and Dressing Clergyman
Shaving s PlL sician _.'. _
CortcfUins y
beeping Body on Ice Number of Burial Certificate.........._...._..�._.__...._
Disinfecting Rooms Kim_._...--.,_
Cause of Deat1L__.!1.:43cs`y._.
Use of Catafalque and Drapery _
Folding Chairs Date of Death—'���'�—� ��s�� —
Candelabrum Occupation of the Deceased.1/
Candles Single. or ATarried ...... ,--..__—Religion
-
Gloves
Crape . '
Body to be shippedNumber of Carriages _................._.._.
to --•--
Hearse . • • • Si:,e and Style of Casket or Coffin.. --
Wagon Deliveries.... ........ .... ....... — ................ _____..._.__. — -----
Death Notices in...........................Newspapers .
,lI<Lnufactured
...—._.._...._......._—_.—
txamed of xuwspapers) .4iet allic Lining---------�
Flowers .
Outlay for Lot • ' Outside Box t
rnterment at-eLllt._.... ..-Cemetery.
Opening Grave y�-
Lining Grave Lot or Grave ,No. _ 1.._..... .......... _Section NO-
-Shipping Charges, p1epaid 1' ---'"`•_....................... _--•---
Rernoval Charges • 3.----.__•_--_—__.
Cremation Charges • g•
g-..._....._.._ ----._............_---••-•—....._.. ............... ...............
• �- 4.
............._ ._. -
4 b
b,...._....._..__.._._._.____.__...___.....
- 0 F
a• Total Footing of Bill (Diagraw of Lot.)
By Amount Pa:d in Advance 3 1 etc.), and marl
Designate all Graves in Lot with numbers (1, , .•, , • �
(Utagno, of Lot.) •Face for this Funeral with a cross (•i•)•
Designate all Graves in Lot with numbers (1 2 3 4 etc, and mark Ralarrr a Designate place for Monument with a small square those
B
space for this Funeral with , Use space to the rightof Diagram for the names of those buried in Lot
rice of Casket or Coffin 41
Metallic Lining • • • •
Outside Box
Grave Vault . • •
Burial Robe . • • • •
Burial Slippers and Hose .
,mbalmingBody (with _....... ........ _... _.................... F7uid
Washing and Dressing . . . . .
Shaving . . • • • • • .
Keeping Body on Ice . . . . .
Disinfecting Rooms
Use of Catafalque and Drapery .
Folding Chairs .
" Candelabrum .
Candles . • • • • • •
Gloves • • •
Crape . . . . . .
Number of Carriages ......__..._—....... 0 $__--------- _..
Hearse . . • • • '
Wagon Deliveries ............... ... — _------•
Death Notices in ...............Newspapers
(\amra of :IewepaPC" 1
Flowers
Outlay for Lot • • • • . '
Opening Grave
Lining Grave
Shipping Charges, prepaid
IRemoval Charges .
Cremation Charges
Total Footing of Bill . • • • ' °1
By Amount Paid in Advance
Balance
Entered into Ledger, Page or below.
...-._--._.--- —
°mPgetf 6y R d. FEINEMAN, St. Louts, Mo., to ttte year 1900,