HomeMy WebLinkAboutCemBK1901to1907pg134,135-0080134 RECORDFr.
-_- _- RECORD OF FUNERAL.
ate.<�
19.__f
No,
Name of the Deceased --... __— Name of tlae Deceased._ :_�� __. __:__.(-
J
Charge to Charge to_------..---
_--------"`- I Price of Casket or Coffin I
liven by Orders Price of Casket or Coffin $ - ----
Order •' Mdallie Lining �—
How secured •' Outside Box gow secured ---- -- -- " Metallic Lining . . . __...__._ _.._._....
Funeral___ - - -_ �` .---- " Outside Box . . . . I_._... ...
Data of Funeral f, Grave Vault Date of . • , ,
/! Grave Vault
" Burial Robe Funeral Services at . --t' -? - -
Funeral Services at ��� �R l •, • . . .
_ Burial Slippers and Hose Funeral Services . U_!L r- �' r-jL -�'lY- Burial Sobeand Hose quid )'
Funera Sery s gmbalmfn Bodj ('with..._..__.............__..__. _ Fluid me f • Time of o _. - �••�tt PP -.
-- — 9 ' j _ f� ,rL. L_.__i__ _ EmbalmatgBody (with
" Clergyman
Clergyman an �� Washing and Dressing _ L ( n ress
' _ � � • � C . � Washing a d D ing
Csrtifying Physics _ Cortifyins physician��� e ... . . . -
Shaving Shaving
Burial Certifreat - -- Keeping Body on Ice
Burial C r ijl a a_._ ------ ing Body on Ice Number of '
Number of
Disinfecting Rooms ) ' Z. j /= J,.'1==' Disinfecting Rooms •
I �- DeatJb_-__;-11 .�_ _ _.._._.... __--
Deatla�`"" f g Cause of
Cause of Use of Catafalque and Drapery ; Use of Catafalque and Drapery . . • -
Death-,
Date of Death / - •' Folding Chairs , . . Date of ;' •' Folding Chairs - -
" Candelabrum Occupation of the Deceased `L� " Candelabrum • • • -
Occupation of the Deceased f -_.
J`/�l,seligiun O - • Candles Single or. Married.�eli,siory es Candl
Single or ,carried - Gloves _ _ .... _....
r s Dat s. Gloves g�sed_�) / Yaars_..... ✓((Dallis, .� Days. Crape
agedU� Years, _Month ,- J ' -»
Crape o
__-_
Body to be shipped to Number of Carriages ............................ ____ Body to be sTbapped to Number of Carriages...._...__._.__.._... - --
Size and Style of Casket or Co n Hearse . �'i . _ Size and Style of Casket or Coffin_---- -- - Hearse . �-
f j"i Wagon Deliveries __--.--..-_. _..__. __._._-___....._ __...._.__
Wagon Delivertes.......... ...... _..... . ........................ _ . - Death Notices in._._._._ -._Newspapers __-
Death Notices in..........................Newspapers — llarbufaetured by_.________.__.__ __._.__------ _........ -
Manufactured by (�amee of Yewfpapen> _
-- Flowers . . . . . .
Metallic Lining Flowers (xames.fNtlwspapera) dletallie Lining — -
_ Outlay for Lot
Outside Box ._ Outlay for Lot Outside Box r_ '- -7 Opening Grave
_ _ //// _jr�/ Cemetery
Opening Grave - Irterment at SL ` z . ' Lining Grave . . --
p 9 g fie aid .
Interment at_ _ ..�_ . _ Cemetery. -••••..._Section JVo•;�._--_------ Shipping Charges, p • p
�i Lining Grave Lot or Grave .No. _ _._ . . jZernovat Charges
Lot or �.._.___Section No•— (-- _ --
Shipping Charges, prepaid �- 1.
___....._...._...._........_. Crematior Charges .
1 • Removal Charges
L — —
,I-
2. Cremation Charges . _....---•_-_._ ---- -
- S.
�u
_ I
_.... — —
4 —
�I 4. � I Total Footing of Bill
s.
By Amount Pa.•d in Advance I --- —
8• Total F t' f B'll
(Diagram of Lot.)
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
space for this Funeral with a cross (•p).
Designate place for Monument with a small square (0).
Usespaca to the rightof Diagram for the names of those buried in Lot,
To Funeral Charges______.Tofa1 $
0o sago f
By Amount Paa'd in Advance
Balance
Entered into Ledger, page ... ........... _..... ....... or vCW -
- -.... ....... .... I___ IBv Cash ._--------
Compileo b f ._... I ....... .... I .... ................._.._
Y F. J, FEINEMAN, SL Louis, Mo.. In the year 1900.
�•�., (Ulagram of Lot.) Balance
Designate all Graves in Lot with numbers (1, 2, 3, 41 eta), and mark
space for this Funeral with a cross (•f•)•
Designate a _ ._..._.._.__ ..orb_" ow.
gnats place for Monument with a small square (i7) er, a
Use space to the rightof Diagram for the names of those be
iaLot. Entered into Ledger, Page
—
`/ _
. 'ey Cash.._._......_...__.._..-..___-- 3
Total, .._._._._......I-
s __
i
L.....__, Irlo Funeral Charges—.__— ..___._. __..._...
.._....._.... __._.....
..
--
- � St LouU, bfQ•
i Complied by F. J. FEfNEAfAN•