HomeMy WebLinkAboutCemBK1901to1907pg148,149-0087OF FUNERAL
RECORD
1 I_ � t_ 1 `� T
( )
Date.._..
Deceased'
Name of the
Charge to __.___.
.----� _-_` �
I Price of Casket or Coffin S
Order given by --'�— ��-
4' Metallic Lining
r ur
How secured._--• � ___.---
44 Outside Box
Funeral
of �.!_.__
" Grave Vault
Data
Funeral Services at ._..._.
' Burial Robe
Burial Slippers and Hose ,
Funer Services _
Time of ....
Bodt (with .............................
Embalming � � ............_. F(a;dl
' Jr Y
Washing and Dressing .
Clergyman
n > ._
Shaving
Certifying physicia
I Keeping Body on Ice
Number of Burial Carl' -ti cafe - Disinfecting Rooms
Cause of Death
�j Use of Catafalque and Drapery .
Date of Death
" Folding Chairs
Occupation of t e Deceased � --
" Candelabrum
4 IL Religion
Single or MarriedGloves
Candles
Jlionths, _ --Days.
Aged.�2---Years, �- Crape .
Body to be shipped to
Number of Carriages._..._ ................
Size and Style of Casket or Cofji►a
. '
HearseWagon Deliveries....._.__ _.....- _------------ _....__..--
_
Death Notices in...........................Newspapers ,
Manufactured by_____---------------'-
Metallic Lining
Outside Box
Interment at t ____Cemetery
Lot or Grave No.—..._ Section No•
2.
�t C4.
s.
8.
of Newspapers )
Flowers .
Outlay for Lot
Opening Grave
Lining Grave
Shipping Charges, prepaid
IRemoval Charges
Cremation Charges
(WAU m of Lot.)
Designate all Graves in Lot with numbers (I t 2) 3, 4, etc.), and mark
space for this Funeral with a cross (•p).
Designate place for Monument with a small square (13) •
Use space to the rightof Diagram for the names of those buried in Lot.
To Funeral Charges.._...Tolal, $
I
Total Footing of Bill
By Amount Fatid in Advance
Balance
RECORD OF FUNERAL..
t
/ Date..:. .? r / 9,fo
/ice
Nante of l
the Deeeasea__-+�--�-___ _.x.___ _ ___' ---- --- •----•---
Charge to----- - - - — -
- --
i
Order triven, by
Price o f Casket or Coffin $I _.._
How secured___.-------- --
3
Metallic Lining
Date of Funeral.._. ��! _ ---
Outside Box
Grave Vault
Funeral Services at _.-...-_-•--- L7=` +`
rQ.�......"
Burial Robe
Time of Funeral Services ...._ _ -
C._- ___—.-_-._.__....--
Burial Slippers and Hose !I ....._..._. ._....
EmbalmingBody(with_.......__...__.....---•-.-__Fluid)IL..._.._ ---....._
Clergyman �`
Washing and Dressing . . . I ...__..._-._..____
_
6 Ph, — - _ __.__
CertifyLns
Shaving ...... .............
of Burial Certifleate....._._ ___ ____ _ -.._ •-
Keeping Body on Ice . -
,Number
�_ .
Disinfecting Rooins
cause of Death.'�+1/�»L`e ,�lrl��:1���
---
Useof CatafalqueandDrapery — - --
Date of DeatTc—�� -
Folding Chairs . . . . _.._
occupation of the Decease .___ __-.-
—__.._.
Candelabrum
Candles . . . . . .---------
Single or •Married..��j�-Religion
.
n Jllonths, ..._.`'............Days.
Gloves . . . . . .
Crape . ..
Body to be skipped to __..-._._..._._...._____-....-.-....__
Nurnber of Carriages .......... @ $..................
Size and Style of Casket or Coffiin..._._._....__._._.__.._.--..--._--
Hearse . • -
Wagon Deliveries ------_._._....._. ......_.._
------- - --
, Death Notices in..........._._...__.. ewspapers I
Entered into Ledger, page- f l'`
_L_.._........... ... IBy Cash-- ..""`.
.dlanufactured-
4letallic Lining- • ____.-- -'
Outside Box
Interment at ��>����1=.,-._.Cemetery.
Lot or Grave No.___- ...... section No.---•-
1-s.��
/f . _.....yA
4.
6. __— .......
.....
(Diagram of Lot.)
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mat
p:,cu for this Funeral with a cross (•I•)•
Designate place for' Monument with a small square (0)•
Use space to the right of Diagram for the names of those buried in Lc
I........... ITo Funeral Charges---•—.Tolal, $i..... ........... _
P �Y
(Names of Newspa9ers )
Rowers
Outlay for Lot
Opening Grave .
Lining Grave
Shipping Charges, prepaid
IRerrroval Charges
Cremation Charges ,
Total Footing of Bill . • • • ,
By Amount Pa:d in Advance • •
k I Balance
p or beloay.Il i
L. Entered into Ledger, age.-._....._.._._..
_..._....... -
�B$
y Cash —...__.._ _ _.--- -_—
j I ............_.._.__._.........---..__.._.
_. ..............
I__.......... ... ............ .......... __....._._._._---- .............. _—.- ...
._.... -
..... ......
-I
CornPltad by F. J. FEINEAIAN. St. Louts, Alo, In the Year 1900.
,p
Compll�d Gy F. J. FEI NEMAN, St. Louis, Mo., In the year 1900-