HomeMy WebLinkAboutCemBK1901to1907pg146,147-0086a
OF FUNERAL.
IZEcOR
No-____- -1
Nanze of the Deceased
Charge
Order given by _ ---
Sow secured_---�
Date of
• Funeral ' � 1 `
Funeral Services
�CI�
Time of Funeral Services-••L-� -
Clergyman � " �•--___._.
Certifying physician
_
Number of Burial Certifteate -• f
Cause of Death -A
Date of Death
Occupation of the Deceased
ligion�J
Single or Married Re
,gged(� I Years, ._Lt_.- Months, J-1E_._..Days.
Body to be shipped to
Size and Style of Casket or Coffin
Manufactured ----
Metallic Lining -
Outside Box pp
Interment at �' f---Cemetery.
Lot or Grave No. No -
Price of Casket of- Coffin $
�• Metallic Lining
Outside Box
Grave Vault •
Burial Robe
Burial Slippers and Hose
ErnbalmingBody ( with ... ..... .......................... ...... ..�u,��
Wasfung and Dressing .
Shaving
Keeping Body on Ice
Disinfecting Rooms
Use of Catafalque and Drapery .
41 Folding Chairs
40 Candelabrum • •
Candles
Gloves
Crape . • ' • • •
Number of Carriages............ ... ... I G. $....
Hearse . • • • . '
Wagon Deliveries ................... _............... .........._
Death Notices in ............ _..... _Newspapers
Rowers '
Outlay for Lot
Opening Grave
Lining Grave
Shipping Charges, prepaid
Removal Charges
Cremation Charges .
a--— ...........................
8.
4.
6.
a.
(Dlagtam of Lot.)
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
space for this Funeral with a cross (d.).
Designate place for Monument with a small square (0).
` Usespace to the rightof Diagram for the names of those buried in Lot.
-- To Fonerat Charges Total �
$ I ....... ...... _..
Total Footing of Bill • • '
By Amount Paid in Advance • '
Balance • '
RZEcoRD op FUNERAL. -14
Date_. /L<< zr__t_
No. -----
7yanae of the Deceased_-41-
or below)•;
Entered into Ledger, page--- `-`
Cash.
cliarle to---._--
riven by
Order y Price of Casket or Coffin •
Iloty secured----.- -----� - Metallic Lining
Il'uneral... _' 1�!--!'--'--'-� -=-t- -- out
Box
Date of f ,����� _,/ - •� Grave vault
Funeral Services at ._7 ' . . •
urial BRobe
Time of Funeral Services ..._�_l11------ •- Burial Slippers and Hose
r a Embalmin Bod with . Nuit
� 9 Y(
Clergyman - Washing and Dressing
r physician, 1Lt l ���1 �j-.........._ .
C>rtifytns y ...... Shaving
,Number of Burial Certifl.eate__...._.__..____- Keeping Body oil Ice
Deat)c'�L!'��_...._.____....._....._.. Disinfecting Rooms
Cause of U. f Catafalque and Drapery
Date of Death,1 rlyl / - •• Folding Chairs . . •
Occupation of the Deceased - Candelabrum .
Ir �t2aj -Religion Al[-_�'__ Candles • • • • • • .
Single or J►7arried..'...%llc= Gloves ,gged.-111....... ...Y'ears,--.G.......... months, ...:3-�._-Days. . . . . . . ' Crape . . . . . .
Body to be shipped to-___---- --.._..—__ ----._............ Number of Carriages. ........_._._...... .......0$............
...
Size and Style of Casket or Coffin ---- ___.__...__.---- ------ _.-_ Hearse . • • • •
Wagon Deliveries.....__....__....
... -...... . ------ --- --- - Death Notices in..........................Newspapers .
....._. _..__.
Manufacturedby _- -- -_,.._..........._...............
----'-'—"-----•-� (Names of Nawepapen l
Aletallie Lining --- --- -- Flowers
Outtay for Lot . . .
Outside Boa _.__.._ ___------/---- ---- Opening Grave . . . .
Interment at --..-Cemetery' Lining Grave . • • • • • '
3 Shipping Charges, prepaid
Lot o, Grave-#o.-- � rf_ ..........Sectiorz<3Ya•�•-=tom ='-
Removal Charges • '
i. _. _._................_...._.
--�---"� - ' Cremation Charges .
4 —
G.
Total Footing of Bill
' By Amount Paid in Advance
(Diagram of Lot.)
Designate all Graves in Lot with numbers (1, 213, 4, etc.), and mark
space for this Funeral with a cross (d•).
Designate place for Monument with a small square (0)-
6 Usespace to the rightof Diagram forthe namesof those buriedinLot.
Funeral Charges-- —•-.•. • Total, $
Balance • • • • •
llEntered into Ledger, page..._..._...___.._.. or below.
-- I
By
$ —... . Cash--._._.__.___._._—
...._._--- ---- I I
........... .............. _..._..__.._.....�_ _ _.
GOmpllwl by F. J. FEINEAfA N, St. Louts, Aro., in tho Year 1900.
LomPlle by F. J,
FEiNEAfAN, St. Lours, Mo., rn ttic yenr. 1D00•