HomeMy WebLinkAboutCemBK1901to1907pg132,133-0079D OF F:UNERAL.
RECORDate .��_�°...:.... _
. ,
the Deceased —•-_�`
dlanle of -- .—_---- ��
Charge to_. —�— _ --
Priee of Casket or Coffin S
Order given by- -------------- " Metallic Lining
]row secured_._-� " Outside Box
•' Grave Vault
llO'
' Date of Fjen.eral�'�='�`
__-------'"—�- " Burial Robe
Funeral Services at
Services Burial Slippers and Hose
Tulle of Funeral Se - E'n:balmingBody(with.................................... .... .. Floid�
Clergyman Washing and Dressing .
�. �.a-=��--....__
C^rtifyins 1`11 sician Shaving
Burial Cer/// tata___--•• Keeping Body on Ice
Number of Disinfecting Rooms
Cause of Death / _ Use of Catafalque and Drapery .
i
Date of Deatic - Folding Chairs
Occupation of
the Deceased " Candelabrum
II
Single or ,AlarriedPl Religion ---- '- Candles
Days. Gloves •
.Aged years, -.- Months, _ _ - (;rape
Body to be shipped to Number of Carriages_ ......... .... .......... ...._ C ....
Size and Style of Casket or Coffin Hearse .
Wagon Deliveries ...................... . .............. .....
Death Notices in..........................N ewspapers
Manufactured by_.- I -------._------- ...... _.......
(Names of Newspapers )
Metallic Lining Flowers
Outside Box.- Outlay for Lot
Opening Grave
Interment at Cemetery, Lining Grave
LeterGraysJhq•Gie_L�C[�-SseEiortNr�•�nQ— Shipping Charges, prepaid
II' �__._._._... Removal Cbarges
z, Cremation Charges .
a. .................... --•---..._...................._..__-_.......................
...........
4.
_. ........ _..__.................. _.— .............
_
b.
Total Footing of Bill
- _ R1, A t P `d in Advance
(D,a moon a><
gnm of Lot.)
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
space for this Funeral with a cross (d.)• Balance
Designate place for Monument with a small square (13).
Use space to the rightof Diagmm for the names of those buried inLot. Entered into Ledger, pageor bel0'
...........................
Funeral Char es.____._ —Total,
i
$...._.._._-- ... By Cask....-__._......____.
RECORD OF FUNERAL.
Marne of the
Charge ---
Order FPrice-of Casket or Coffin $ •-- --
Ilour secured---- _- ---- Metallic Lining
0 .... -7 D_J&i�-._.----- Outside Box
Date of Funeral_. LC..
m " Grave Vault
ir*y r ,,La..........._
Funeral Services at - . _ •' Burial Robe II '---.- -
Funeral Services..., -- .. Burial Slippers and Hose
Time of Fluid )I
_ EmbalrningBody (with ....._.__......... _..
Clergyman Washing and Dressing - -
Plt sician�/._. ........ ..._..... ........_.__
C<rtifytng y Shaving . . . . . . . i _....._
Burial Certtftcate............_... __-_..-..._. Keeping Body on Ice • • - ---.
Number of �- �
Deatic.S[� Disinfecting Rooms �...... ---
Cause of
Date of Death lip/r' °'� �- frQl __..--
Use of Catafalque and Drapery ���,---'---I-----
� -� Folding Chairs - --
""^ " Candelabrum _
Occupation of the Deceased �'�� � --• -- -"'
Religion �.. -
Candles . . . - - - Single or Jl2arrted..-�._ - (',loves -�--
rllonths, ....Ll........__.Days.
Crapegged..._._�.........Years, .................. . . . .
-.----- Number of Carriages _.............__._..... C $......... .............
-
Body to be shipped to -.-.----
Hearse . -`__-
Size and Style of Casket or Cofj'in_._-.
-- - - .
Wagon Deliveries_ .................. _._........_..._.____._... _ ......__...__
_._. -• Death Notices in ........... _......._.... Newspapers ---.---. ---
jllaltufaetured bl/------ _--- ---- - (%amea ot:.eweDaP<rs)
Metallic Lining___--------- Flowers _ u
_ Outlay for Lot
Outside Box -...__-- Opening Grave - --- -
,(( -Cemetery- -_-..-_ ... ._._.
L-aterment at. rlFrfttre�_Lining Grave
9
Lot or Grave No._.._ ..........._Section No•- - Shipping Charges, prepaid
Removal Charges , _ -
><. t _....._
............._......._. -_
._..._..._.-_..._... Cremation Charges . .
'L
4• ._.......___--—
.._..__.__..._—.
._..... _-._-___._.._.__. I Total Footing of Bill
__••-_.______.__.___....._.._......... By Amount Pa;d in Advance
(Diagram of Lot.)
Desi nate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
Balance • • • ' '
�p.rtc for this Funeral with a cross (•I•)• . Or below.
Dc,ignato place for Monument with a small square (0e age "' -
Usespace to the rightof Diagram for the names of those buriedinLot. Eittered into Ledger, p g --
- I ...__. IBy Cash
Total, $I.._.. _._.__..
t....... _...._.. `fo Funeral Charges------
_...
.__................_...___-....._.._.__._.
__..... .........._. _ _...._. ._.......... _.._._....._......_— .I— —' .._..........................
_ I
_.. __..... _ _
ComPlled DY
F. J. FEINEtfAN. SG Louts, Afa, !n tl+u Ye+r 1900.
_._........_Cc ... ................
Hued by F J. FE .___.... ...
1NEMAN, SL Louis, hfo., In Cho Year 1000•