HomeMy WebLinkAboutCemBK1901to1907pg174,175-0100,
D OF FR
UNERAL.
ECOR
4 r
Nance of the Deceased_ _
Charge to_---`"-�— ----
--- " `"'� price of Casket or Coffin
fin
Order given by - - 11 Metallic Lining 3
How secured Outside Box
--" Grave Vault
Date of Funeral_------ -- _
Burial Robe
Funeral Services at _.- -- ----`
- Burial Slippers and Hose ,
Time of Funeral Services ._._.___ __ _ E'.... Fluid)
_....__._ mbal»iingBody (with........._._...___.............
Clergyman;------' Washing and Dressing .
ng Plc sician.._.._--.. Shaving _ _____ _
C,rtcfyiy _
Keeping Body on Ice
Number of Burial Certijlcata- -- Disinfecting Rooms
Cause of Death-- Use of Catafalque and Drapery .
Date of Death - " Folding Chairs
Occupation of the Deceased
14 Candelabrum
Single or,Married.____—gelZoon - -- Candles
Days. Gloves
Aged Years, _ _._. ,M-
onths, -- Crape .
Body to be shipped to Number of Carr•iages..............._.......... _ �� $._.......
Size and Style of Casket or Coffin-_------- Hearse .
Wagon Deliveries ....................... __-------------
Death Notices in ... ........... ...........Newspapers
ganufactured by-.--_ ...........____.__..._ .
....._.__(Names of Newspapers )
,Metallic Lining Flowers
Outside Box _ Outlay for Lot
Opening Grave
Interment at.__. -._— —_Cemetery.
Lining Grave
Lot or Grave No. ___ .._ _ Section No. Shipping Charges, prepaid
Removal Charges
I( a, -__- Cremation Charges
............— ............. I.........
b. S
(12 T D ni Total Footing of Bill ;
(Diagram of Leta -ll By Amount Paid in Advance
Designate all Gravea fn Lot with numbers (1, 2, 31 4, etc.), and mark
space for this Funeral with a cross (•p), Balance
Designate place for Monument with a small square (0).
Use space to the right of Diagram for the names of those buried inLot. Entehedinto Ledger a or belo
�-
-_. TO Funeral Chi I
rges. By
- Tolat, 3 ....._..._... ...
RECORD OF FUNERAL.
C
Date _....Tizo:_..__ _-__----
Nance of the
Charg
Order given
Price of Casket or Coffin +
Ilow secured _ •---- -- `-"— -- ---
Metallic Lining
Date of P'uneral_�_---7 1 0 7=--------
Outside Box
dB '
Grave Vault ,
Funeral Services a --------- -------- -
Burial Robe
Tinte of Funeral Services ....... .......
.. Burial Slippers and Hose
_..__._._._.._..-.__—_........._
EmbalmingBody(with......__...._....._........._..._.Fluia
Clerggrnan-----------"
Washing and Dressing . .
s Physician-.�-�ae�•l"e..__......._........_._
Cartifyins
Shaving .
of Burial Certifi•eats---------- _ ____.._ _._.._.. ..
Keeping Body oil Ice .
,Number
of Death.. -�_, Z ,GP�e•u o,�.__.._..._..._....._._.._........_
Disinfecting Rooms
Cause
� h o� ----
Use of tafalque and Drapery
Ca
Data of Death,—`-'
f�""
�� Folding Chairs . . . . ,
�•
Occupation of the Deceased _Pu'.�a-�i"-
Candelabrum
Single or .Married.. ryte,,, !,L . Relt gion �.__—_-
Candles • • '
' '
Aged_......Y'eara, ...._._._....... months . ............. .....Days.
-_.-.
Gloves . . • •
Crape
Body to be shipped to—__._--------- --- ...
Number of Carriages -.-.....-------®$--............
Size and Style of Casket or Coffin...._.._..------------
Hearse . • ' ' ' '
Wagon Deliveries ..._.... ..... _.... __ ---
---------
Death Notices in -- -------- ....._..._Newspapers
.Manufactured by--_......______----......,—_-- _ _ --
i —�. _ .�_._
(Names..of NewsPaDen)
lfefallie Lining- ------- ----
Flowers _
Outlay for Lot
Outside Box _
Opening Grave • '
` 9....Centefery. Grave
Interment at r • Co='+ __.._Lining
Lot or Grave No. %/._ .........._Section No. `j------
Shipping Charges, prepaid
,�
Removal Charges
_......__.___..._.._._. _.
Cremation Ciarges . .
3.
....... _......__.
4. __...._....-....
5.
--- ' "-- --
Total Footing of Bill
es. __. _..............
Amount Paid in Advance
(Diagram of Lot.)
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
q,uce for this Funeral with a cross (•f•)•
Designate place for Monument with a small square (0)-
a Usespace to the rightof Dingram for the names of those buried inLot.
To Funeral Charges -------- Tolal, b ........
........
.
By
Balance
Entered into Ledger, page ----------_------- or below.
�,By Cash ------- -_.-.______--.__-- $
_—�..---_ .._._.__...._.___. _..
...... .
._.......
fo.I,, tile year t900.
J. FEINENAN, 51- Louis, h,
Compiled by
F.
cornDlfe. j. ,EIIVEMAN,—SL Louis, Ma, in the year 1900•