HomeMy WebLinkAboutCemBK1901to1907pg136,137-0081L
RECORD OF FUNERAL.
136
Xame of the Deceased _
Charge
Order given-
llow secured--•-�
Date (Funeral r,
1'tcrteral Services at-=�,�•�'
Time of FeLneral Services _•s? -
G
man
Clerga y
�f
CrlcfyL•ng y PlL sician --
,
Number of Burial Certiflca e._..___._
Cause of
Date of Death
Occupation of the Deceased
Single or ,)}tarried_ - —
Religion ---may—
Months, _!? -Days.
Body to be shipped to
Size and Style of Casket or Col n
Manufactured by
Metallic Lining
Outside Box. —
Interment at r VI XV -Cemetery.
Lot ori^raveNo..._. .__..._..SectionNo. Ll t r
e.
4.
G_.__..._
6.
Price of Casket or Coffin
fin
Metallic Lining ,
Outside Box
Grave Vault •
Burial Robe .
Burial Slippers and Hose ,
EmbalrningBody (with ..... ..... .......... ........... __.
Washing and Dressing .
Shaving
Keeping Body on Ice
Disinfecting Rooms
Use of CatafalquearldDrapely .
Folding Chairs . ,
Candelabrum .
Candles
Gloves
Crape. . . . . . . .
Number of Carriages .........._.................. C $.........
Hearse .
Wagon Deliveries........ ..._ ....................... ....
Death Notices in.......................Newspapers
(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 \lonument with a small square (a), Use space to the right of Diagram for the names of those buriedinLot.
" `0 Funeral Charges Total, $
-- -
-
RECORD OF FUNERAL.
NoDeeeased__���!"
Araine of
the $ Charge
Order 1
flow secured
Date of '
Funeral Services at ��.c..iy���=lir
Time o/
p Funeral Services
� �-
Fluid ` i , , (' C,L f
Clergyman
0
(Names u[ Newspapers
rw)
Roers
Outlay for Lot
Opening Grave
Lining Grave . .
Shipping Charges, prepaid
CortifyLns s PlLy sician._�a
~ 1y'umber of Burial Certift.cate...___..
f
Cause o Death. ,
%�-
Date of DeatlL '—F
N/, :
_ Occupation of the Deceased
Single or .Married _=_ Religion
gged--........_...._Years, .._._.......-. . illonths......f-�'_.—Days.
Body to be shipped to _� --.--
_ Size and Style of Casket or Coffin -----..._..___-_•-__--
lianufactured by_.___.-------'-'- ----- -
�j Iletal..lic—
Outside Box --
Interment at_1...1_
Lot or Grave No. L • •••--Section Na•��u/i2
.1.
Removal Charges
Cremation Charges . s _
_. 4.
Total Footing of Bill • • • ' ' $
By Amount Pa:d in Advance
Balance
or betoO,
Entered into Ledger, page .................._......... I�
IBv Cash_-_------
— _.._._._........
on,pp� Dy R J, FEINEMAN, St.
Louis, MO., in u,0 year 1900.
ice of Casket or Coffin
Metallic Lining
" Outside Box • • • •
Grave Vault
" Burial Robe
Burial Slippers and Hose
imbalmingBody (with ..... .......................... Flufd )
I
Vashing and Dressing
'having . . . . . . . .
beeping Body on Ice . I --
Disinfecting Rooms
Use of Catafalque and Drapery
Folding Chairs . . . .
Candelabrum • • • • • I --------
Candles . . . .... _
Gloves . . . . . . • • I
Crape . . . . .___---
Number of Carriages .._.._..........._ n $.................. ... .. _.__.
Hearse . . . . . . . .
Wagon Deliveries -
Death Notices in ....... ._._... ... ... Newspapers
1
(\times of \eFspaDen 1
Flowers
Outlay for Lot • • • • • '
Opening Grave
Lining Grave
Shipping Charges, prepaid
Removal Charges
Cremation Charges
Total Footing of Bill
By Amount Pa;d in Advance
(Diagram of Lot.) Balance '
Designate all Graves in Lot with numbers (1, 2, 3, •l) etc.), and mark
since for this Funeral f with a cross with
-
Designate pinto for Monument with a small square ((])• Page �--'--��`-"" " _
or below. ,
line space to the rightof Diagram for the names of those buriedinLot. 1 Entered into �' p g
I
,Sy Cash-------•---
;_.... ....... ...._........ To Funeral Charges._._.._._._. $......:..... _ _.......
__.
_ ..... ........ .
_._.