HomeMy WebLinkAboutCemBK1901to1907pg164,165-0095s
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OF FUNERAL;
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164 Date -1 :....__. -�%
,brace---'- �r-�_.-•� �
the Deceased
Name 0f
— "-
CTlarge to ----'� I
Price of Casket or Coffin
Order given by - - ---
40 Metallic Lining
Flow
" Outside Box
of Funeral -
�` Grave Vault
Date L
41 Burial Robe
Funeral Services at - _
.. Burial Slippers and Hose
Time of Fu�,eral Servwwas .-
-
EmbalmingBody (with .......... ..... ...... ._... ......... ...._
-
Washing and Dressing .
Clergyman .
--
Shaving
physician
Certifying y
Keeping Body on Ice
Burial Certifl ate_.•--/%- f
Number of _
/
Disinfecting Rooms
Death '
Use of Catafalque and Drapery .
Cause of
Date of Death
" Folding Chairs , .
Occupation of the Deceased
Candelabrum
`I ;
1
Religion
andles
+o
Single or tfarried^^ 1
i Months, .-� j---Days.
Gloves
Abed � _years, _1
Crape
Body to be sTrcpped to--------- ----
Number of Carriages _ ...................._. �_
g
'
Size and Style of Casket or Cofftrt .._.__-_ - —
.
HearseWagon Deliveries .............. __...............__....._....._
_- -� _---
Death Notices in....... ..... ............ Newspapers .
Manufactured y_._.___-_..____.._..
•
..........
(Names of Newspapers)
Metallic Lining--___--------
Flowers ;
Outlay for Lot
Outside Boa _ —
Opening Grave
Interment at ___--Cemetery.
Lining Grave
Lot or Grave No.;}__/o° Section No•�-y Shipping Charges, prepaid
1,
l Removal Charges
Cremation Charges
...........
__...... ......
s, Total Footing of Bill . • •
_ By Amount Pad in Advance
(Diagram of Lot.)
Designate all Graves in Lot with numbers (11203, 4, etc.), and mark Balance ' space for this Funcral with a cross (.p).
Designate place for Monument with a small square (a). or below,
Use space to the rightof Diagram for e names of those buried in Lot.
-.. the Entered into Ledger, page ....................
_. % Funeral Charges Tofal, $
Cash-.- - -- -''
.... _......
I ......_. _ _ ...__. _ ......_.._.
RECORD OF FUNERAL..
—-----------------
the Deceased....% _.�1 4il�-..__-___._._..._..._.__..___ — --
.Arame of
�- -- --- -
Order given by
Price of Casket or Coffin . $ -
Flow secured - --- - !, Metallic Lining
Date of
Funeral�l'= �./�F1 %-------- Outside Box •
/ Grave Vault . ) - - -
Funeral Services at "- /- ---- -- Burial Robe
Funeral Services _ 2...f!�L?_L2.........»-. „
Ttnye of Srvis / Burial Slippers and Hose
Clergyman
v ,= ..9a tfFca._...__.—__.____ EmbalmingBody(with ...... .._......... __.__._..._._.Fluid) ........ ...__._ .
/ Washin and Dressing .
Playsician .. ./l ^ �•._ _.._... ____ 9 9
Certifying Shaving . . . .
Number of Burial CertrJteat/e'..-_.._
`/ -"�-" '" " Keeping Body oil Ice
Lq!•�.rrlLUlra2ll�.. Disinfecting Rooms
Cause of DeatJa-..L.
- Use of Catafalque and Drapery _. I----- --
Date of Deat7b _ /
__...__ Folding Chairs _ -- --- -
�M�F`) Li✓1 n Candelabrum
Occupation of the Deceased.. l .. --
,�,i.;L-
Single or Married- _[ f>=6[� Religion Itlt_t1-__ Candles
- Gloves
,/lged_�- .......Y'ears, ...../.............. ✓Months, ....... %.___._Days.
Crape . . . I --
Body to be shipped to--.-..------ --- -
. Number of Carriages... ........... --- __._ @, $........ _........... _. _ _....
_ Hearse . ..._ ..._... i _- .
Size and Style of Casket or Coffin._.....___._-.- -- -- l; I -
lf(fn.ufactured by_..... _- _----_ ----
Metallic Lining -
Outside Box '�-
�! „u K �i l _ r __Cemetery.
Zrtternzent at__�:�.�--1.�
Lot or Grave .No._�C_.-...........-Section No• �--•----
1 ............ __._......... ....
4.
s. _......_..__........
.
i
(Diagram of Lot.)
Dcslgnate all Graves in Lot with numbers (1, 2, 3, •1, etc-), and mat
1,..cc for this Funeral with a cross (d•)•
Designate place for lfonumont with a small square (G)•
Uaespace to the rightof Diagram for the names of those buried in Lc
......... I To Funeral Charges ------• Total, $
Wagon De fvenes..................... _-__.
Death Notices in....._......_.........Newspapers _ -_--
-- —"—Games of Newspaper)
Flowers
Outlay for Lot
Opening Grave • •
Lining Grave
Shipping Charges, prepaid
IRemoval Charges
Cremation Charges
Total Footing of Bill . • • - ' 'off
By Amount Paid in Advance • I
tt Balance
or below.)
Lered into Ledger, page- --3
�—
'BYh_.- ------
- ... ....
..........._........
.._-_..._..... St- Louis, Alo., in tha year 1900.
Contpited by F.J. FF.INEMAN.
Compiled by F.
J. F
E1NEMgN, SL Lours, Ma, in Ufe year ID00•