HomeMy WebLinkAboutCemBK1901to1907pg124,125-0075IZF
'COIZD OF FUNERAL. �
Date..... A'
ance
Nance of the Deceased-,
I
Charge -
fin
Price of Casket or Coffin
Order given by - --�-�
•' Metallic Lining ,
How see)ired - __
Outside Box ,
Date of Funeral_-------�--- -- _
_
Grave Vault ,
' -'- ^
Services at ---_"- - -�
" Burial Robe .
Funeral
Funeral Services------- - --
.• Burial Slippers and Hose
Time of
EmbalmingBody(,with ....................... .... ..... Fluid)
C�rgyman_�--
Washing and Dressing .
C;rtifying Playsacaan _ ----
Shaving .
Number of Burial Certijteata____- — ----_-
Keeping Body on IceDisinfecting
Rooms
Cause of Death--------"
Use of Catafalque and Drapery .
Date of Death
Folding Chairs
. Occupation of the Deceased „��Y
Candelabrum . .
������ �
Single or Married _JY11mu•�sReligion _—
Candles . . . . • . . •
Sleds Years, �_. Jl2onths,—___ Days.
Gloves
Crape
p
Body to be skipped to
Number of Carriages...._ ..................... ( __
Size and Style of Casket or Cofn__..
Hearse . • • •
WagonDeliveries ....................... _... .... .................. ...- - -
Death Notices in ................... Newspapers .
Manufactured by----------
... . ......... I .............. ........ .
Metallic Lining
(Namesuf Newspapers)
Flowers
Outside Box
Outlay for Lot
Interment at / —Cemetery.
Opening Grave
Lining Grave
Lot or Grace No..(9 -section No•_
Shipping Charges, prepaid
1•
Removal Charges
z. _
Cremation Charges
8.
.................
..........................
6•
Total Footing of Bill
B rd ' Ad
J
RECORD OP FUNERAL.
No. -
Hanle of the
charge
Given by.
Order 5 I
Ilow secured _ - ----- - -
Date of ---
Funeral Services at
-----•---------
----------
Time of Funeral Services ....._--------•• • -
C<rtifyiny_----_..—
Number of Burial Certiffcate..... .....
__---.—.-•.•-
L'atcse o
DeatTt _—_^_.._... . .......
Deat7f._ - L ......_..........._
Date of �p2��2e1a-
occupation of the Deceased_G�T1
Sin4le or ffarried��Religion
.111 onths........_.............. Days.
Aged.._7..��__Y'ears, ..........."........
Body to be shippedto------- -
Size and Style of Casket or Coffin._...
(Diagram of )Al.) y Amount Pa. fn v
Designate all Graves in Lop with numbers (1, 2, 3, 4, etc.), and mark
spaee for this Funeral with a cross (. . Balance
Designate place for Jfonument with a small square (p)•
Use epaee to the r; Entered into Ledger, page ... ............ bale
right of Diagram for the names of those buried in Lot.
— —_ `T� Funeral ar S -
Tolal.1',
a ...._._.. _._ _.................. _ _._... _
_ . - B Cash __.__......-
V t _ (aj-1 /4-7, 1, --o' JI-A ! - . - — I -
�J
'rice of Casket or Coffin - - -
Metallic Lining - --- -
" Outside Box _.__......_ _ ._-
-
GraveVault i _._........_
Burial Robe _...__. ....___._
Burial Slippers and Hose
�'mbalmingBody(with .__........__..___.__....__...F7uid)-----
Washing and Dressing . . • • - '
Shaving . . . . . . .
Keeping Body on Ice - --
Disinfecting Rooms .
Use of Catafalque and Drapery I ----------
Folding Chairs
Candelabrum • • • • • -
Candles • • • • . ' • I ' _--
Gloves . . . . . . . . - -
Crape . . . . . . . . _. -- —
Number of Carriages .........._.__._...._..... 0 ..........._..... _. --....
Hearse . . . . .
Wagon Deliveries...._......__....
Death Notices
_---._...----- P ....._ _._ --
Manufacturect oy — -- "—__._....__.___.--._—..._.____..-.. - (Names of Newepaperel
Flowers • • • .
Outlay for Lot
6ntsiile Bo -as .� Opening Grave .
/ Cemetery.
Interment at— // 'O- Lining Grave
Lot or Grave No.�tr�� action No•- . Shipping Charges, prepaid
1 Removal Charges -
---- �� Cremation Charges . .
s. ____.-.-............................ »...
.
4. _ ..... _.... -
- Total Footing of Bill
a By Amount Pa:d in Advance
(D(a^„ram of Lot.) ' Balance
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
-.parr far this Funeral with a cross ($•)• _.. or below.
Designate place for monument with a small square (G)• -- -
Cse space to the rightof Diagram for the names of those buried inLot. Entered tntOLe gar, pageBy Cash __
. S.
Total.% ii/%�I / 1......� �,//f 11�1�1(._!/l�G�//
__..._
.._L...... __I4oFuneral Charges-.....�..
NO
-_...._.......
Compiled b r•• d p•EINEMAII, St. Louis, Ma, In Uro year 1900.