HomeMy WebLinkAboutCemBK1901to1907pg172,173-0099,
OF FUNERAL.
RECORD
- -
Deceased
__.-- - --
.Hama of
Charge to------
p,iCe of Casket or Coffin
-�,__
Order given by ---""
•' Metallic Lining
How secured._•-•��.
Outside Box
Grave Vault .,
Date of Funeral
t Avg -- _
" Burial Robe
Funeral Services at --- ��h GJ rn ,�
Burial Slippers and Hose
o Funeral Services'
Time f - __..._..
EmbalmingBo6(with ............ _...... ....___.._._._1+luid)
--'"
Washing and Dressing .
Clergyman
Shaving .. ..
Co,rtifying Pltysician ___s�_✓-�-�-�,c.-e...�_.__-----
CertifGeate_-_- -- •---------•
Keeping Body on Ice ,
Number of Burial
Disinfecting Rooms
Cause of Deatlt-
Useof Catafalque and Drapery .
''----
" Folding Chairs
Date of Deatlt a 0
Deceased
di Candelabrum
Occupation of the
Candles
Single or Harried.__•--- Religion _-----
Gloves
0 Years, Months, .._Q_Days.
Crape
,Aged
Body to be shippedto
Number of Carriages ..... .......... _......... ._ C _.
'
Size and Style of Casket or Coin
Hearse .
Wagon Deliveries..... ........... ...... _........ _.....
Death Notices in ..........................Newspapers
dfanufaetured by lNamesulNewspapets)
getallie Lining Flowers
Outside Box Outlay for Lot
/nn J Opening Grave
Interment at iQQl� Lei Cemetery.
Lining Grave .
Lot or Grave No. __.___Section No Shipping Charges, pPepaid
1, Removal Charges
Cremation Charges .
j
Total Footing of Bill
By Amount Paid in Advance
RECORD OF FUNERAL.
No.
Name of tite Deceased_-_._..
Charge to_.._ --------
Order given by - - F
Ilow secure - --- ----- -
Date of Funera .__.._____--__--
Frlrteral Services a - Time of -
Funeral Services .....__.
Clergyman
Cortifyiny
Burial
,Nfnnber of
Guise of Death_____—_ _..------..._...___._.......
..........
......
.....
..._....__
Date of Deatlt —
Occupation of the Deceased.__
Single or 1{Tarried._...___— -Religion
Aced____ --Years, ......._._......... ✓ll on th s............__....... Days.
Body to be sltipped to --------- ----•------
Size and Style of Casket or Coffin......_._..__-_- -
,Manufactured by_ -------- ...______._..__._ _—_-•--
,lietallic Lining.. --- -------
Outside Box ..__—
Iltterment at....___...._..___..---•--.--- ........ .-Cemetery.
Lot or Grave No. _......._...... _ ..............Section No•_—
s. _.._
3. _._
(Diagram of Lot.)
Designate all Graves in Lot with numbers (1, 2,3 , d, etc.), and mark Balance '
space for this Funeral with a cross (•p).
Designate place for \lonument with a small square Q3 bZI0u1'
Usespax to the rightof Diagram for the names of those buried in Lot. Or
Entered into Ledger, page• -�-- -
-
ToTo Funeral
ges---Total, $IBy Cash._..._...
- - +__.............
�._....._.�_... _ ......_.
sled by F. J. FEINEMAN, St Louis, Ma, In the Year 1000.
Date.._._..........
__.. 19...
•ice of Casket or Coffin 4-_... _...._
" Metallic Lining . • • •
--
Outside Box . Grave Vault . . . . . _
Burial Robe
Burial Slippers and Hose
?mbalmingBody(with..._ ...._._......__.__.._.__. __.....___._
Washing and Dressing . . • •
'having . . . • • • •
Weeping Body on Ice . -
Disinfecting Rooms -
Use of Catafalque and Drapery .
Folding Chairs . . . .
Candelabrum --
Candles . . . _..... _ . ..._�.
Gloves . . . . . . .
Crape. . . . . . . . _
Number of Carriages ...... ....... .._.......... . ......................
Hearse . • • ' ---
Wagon Deliveries .._._....._...._.. _—_--•_-.--- .. ___
Death Notices in....._... ------- .._---Newspapers
-_
.........................
-- (Names of New�papen 1
Flowers . . . . . .
Outlay for Lot • • • • . • -"-
Opening Grave -- -- - —
Lining Grave . . . . . -- - - _
Shipping Charges, prepaid
Removal Charges • • • • . • — —
Cremation Charges •--
Total Footing of Bill
By Amourlt Pad in Advance
(Diagram of Lot.) Balance
Designate all Graves in Lot with numbers A, etc.), and mark
(.ace for this Funeral with a cross W. ._._ _ or below.Designate place for Monument with a small square (W- page
Use space to the right of Diagram for the names of those buried inLot. Entered into Ledger, p9 —
------ _ B Cash.. $
To Funeral Cha es----- -_Total, $ I �
_.._._._.. _ _ _...__.._...--------
- . _... ......... _—__._.__ .......... _............. ........ _...__._ . ..._....... _-- — ._.. _._...
............ _......._._..... _ .. .... ............ _. _ ...._I ..............
..... i L..............---.—.._......._.....___._. _ ---
�.
SL Louis. Afo-. In the Year 1900.
% Compltad by F• ✓• FEfNEAfAN.