HomeMy WebLinkAboutCemBK1901to1907pg166,167-0096OF FUNERAL.:.
RECORD - RECORD OF FUNERAL.
f _ _-- -- - —_ _.. __ Name of the Deeea
_
the Deceased _'�_—_,..-
,hranie of _-- _-- ---
Charge to----_.------
_ --`' Casket or Coffin II
Ckar'�e t0-.---'``- ' I Price of given, by ._------._.__. _._..______._........__......._
Order liven by -J " Iffetallic Lining
� Order �'-
Row secured --------
Row secured —
Date Outside Box
Grave vault Date of Funeral
Funeral ` �E.. Burial Robe 'A` �� �
Date °f r—�y Funeral Services at x-
Sery Services at e 4• a L4J
��-- Burial Slippers and HoseFuneral eTime of rfaneral Services .._.._.__._— — .- ............. -
Funeral Serv''eS Embalming Body(with....................................... / — -- ...._._..._...._..__
Time °f -_ _...-...__ � Clergyman — -
Washing and Dressing /n ka&0 _ /
_Certifyin.y Physician n� Q /¢
ClergUman Shaving
Corlifyin� Physician ^ r—_......_
--- Keeping Body oil Ice xamber of Burial Certificate....... _
Burial Certificate ..• t Roonis
Number of � �/ j" Disinfecting Cause of
Cause of DeathUseof Catafalque andDrapery Date of r �� --
Death '�
Death ' " Folding Chairs
Date of I )� Occupation of the Deceased.s
Candelabrum i
eased '
Occupation of the -._._
Candles single or J{Tarried._.'-1�'�tr�s�Reli.6ion y^ .
�
Single or Marrieds lision' Gloves A,, ed. #_-......._.Years, .._.._1....... Xonths, .?. 4......-Days.
J (Z .Months, .�--Days.
Ased �- years, Crape Body to be shipped --
Number of Carriages ......................._.... _ C $..........._
Body to be sliipped to Size, and Style of Casket or Cofj'irz.............—..-------_•-------
Hearse •
Size and Style of Casket or Coln _.___.______' , - ---
Wagon Deliveries ..................... _.
----- --
Death Notices in..._....................Newspapers .
-_ -- Manufactured by-----------------------..--_--_."
-cMpa>er eganufaetured by- -— felallic Lining ----
Metallic Lining Flowers Outside Box
Outlay for Lot ( Ce»etery.
Outside Box _ Opening g Grave Interment at�''Y�----� Win✓
Interment at Cemetery. Lining Grave Lot or Grave No._.Y Section NO.
�
°
Letor-Grcive.N'o. _ ._. - __ _ ._Section No• " Shipping Charges, prepaid 1_<..._.__.._.—......_.._.._.....__.__.....__.
Removal Charges ?__._____ •_-- -
L�� I �'
3U Cremation Charges s.
8.
s.
s.
Total Footing of Bill
By Amount Patid in Advance
(Diagram or Lot.) -
Designate all Gorses in Lot with numbers (1, 2, 3, 4, etc.), and mark !ii Balance
space for this Funeral with a cross (+). °r hz10�'
Designate place for Monument with a small square (p).
sespace to the rightof Diagram for the names of those buriedinLot. Entered into Ledger, Page . -
70 Funeral Chamcs-__.___ Total, $ ! I_ ._ IBy Cash
...........
i
Compiled pY R J, FEINEMAN, year
St Louis, Mo.. In they �j
(Magram of Lot.)
Designate all Grates in Lot with numbers (1, 2, 3, 4, etc.), and marl
space for this Funeral with a cross (•f•)•
Dcsignate place for Monument with n small square (0)•
Use space to the right of Diagram for the names of those buried InLol
yf� / 4
Date_'" ✓Jt!/a�//�r:_-_
'rice of Casket or Coffin $I -- -
Metallic Lining . . .
Outside Box -
Grave Vault .. -
Burial Robe . . • • • - -----
urial
.mbalm�Slippers
and Hose
th.-----_• -Fluid) I
washing and Dressing . . . .
>having . . . . . •
Keeping Body on Ice . . - --
Disinfecting Rooms I� Use of CatafalqueandDrapery Ij---"-- - --
.. . . . . ---
Folding Chairs --•-- --
Candelabrum . • • - --
i
Candles . . . . . . . I ........ .. _..._...
Gloves . . . . . _..._._
Crape . —._..
Number of Carriages $ ................... _.I.....------
--- ..._..............__.. G
Hearse . III- .-......_.......
Wagon Deliveries-__-...._....__ _.__......._....._------._...___ 1....
Death Notices rn..__........... ........ Newspapers
_..._. _
(13mCt Oi "'CN)papCrf )
Powers
Outlay for Lot • • —
Opening Grave "- -
Lining Grave ----_----
Shipping Charges, prepaid _._..._
Removal Charges • --
Cremation Charges .
---
-- — _
........ ......... _..... _ _ — ...-- _ --- ......... I .._..... — _
I
Total Footing of Bill
By Amount Pa;d in Advance
Balance I _...-...._..._ _._.......
r!
)
„ I Entered into Ledger, Page .__...... ..._...... .. or below.
Cast-- — $