HomeMy WebLinkAboutCemBK1901to1907pg28,29-00262g RECOR
FUNERALS
I Date.dl;',...'� V '
C �
N
t
,Name of the Deceased _......
of the Decease
Charge to _..__._..._--• � to_._-•-----
Order given by _---- Price of Casket or Coffin ar'ge
Metallic Lining der 6ivgn by
How secured _ Outside Box ,
Funeral �Iu secured _---
DaEe of �( �y — Grave Roe xle of Funeral_��
Funeral Services at —{ Burial Robe par
Services at
Funeral Sery ' s It !_G--- -' - Burial Slippers and Hose
Time of Funeral Sery
-� ....._ EmbalmingBody (with .......................... ..... ..............Tlutd) ,nze of /� (
Clergyman Washing and Dressing terffyman
RECORD OF FUNERAL.
I
n Pla --
C,rhfyz' g physician U Shaving erEifytnss physician
• --
Number of Burial Certifleate--_-_.�_ ..---. Keeping Body on Ice
' 'tznzber of Burial Certrfr.cats...
........----...----—__......_..._ ,
Cause of Deal lz r —� -- Disinfectrng Rooms ��
G __ Use of Catafalque and Drapery , puss of
Deaths "�- --
Date of Death " t Folding Cbairs pie of Death �� - --- -
Occupation of the Deceased " Candelabrum the Deceased. z
n ( ccupation of
Single or Married ligion Candlesr�
l Ingle or Married----
Aged.�Y'ears, — Months, __. Days. Gloves
Crape aed.. _I �Y'ears, .... .....-._._ .Months . .....
.........Days.
Body to be shipped to Number of Carriages ...............__... G _.... ody to be shipped to_ —..___—_—___--.---•---.--
Size and Style of Casket or Cofjzn— Hearse .
• ire and Style of Casket or Coffin,
Wagon Deliveries ...... ... ............ _............... _
Death Notices in.._._........_._....Newspapers .
Manufactured by �_ 1 Ianufactured
Melallic Lining
Outside Box
bzlernzent at ��1oeA,{------•--.--
Lot or Grave N-n
Section No•&-m—d"7
S.
s._ _
4.
s.
lDl e•tt0 of Lot.l --_. ........
Designate all Grates in Lot with numbers U
space for this Funeral with a cross , 2 3 4
Usegla ft place for „e Dment all�th a small square ctc.), and mark
I�co to the ri
—� 2ram for the those es Of th namse
buried inLot.
a
'9ts Total, $ l
L s� ......
—__..._..............................__...............-._._-
(Names of Nowspapers )
Flowers
Outlay for Lot
Opening Grave
Lining Grave
Shipping Charges, prepaid .
Removal Charges
Cremation Charges .
Total Footing of Bill
By Amount Pattd in Advance
Balance
Erlter'ed into Ledger, page ........................... or bel010•
Cash _.___. IT
letallic Lining
-- lutside Box _
t
'nterment .._.... _Cemetery.
At or Grave No. t* .............Section No•_..._--
1. ....._.....
s.
4.
a.
......... -_...-._.-___._...........
(DlaFram of Lot.) 7.
Designate all Graves in Lot with numbers (1, ?, 3, 4, etc•), and mar
for this Funeral with a cross (+)•
Designate place for Monument with a small square (f])•
Use space to the rightof Diagram for the names of those buried in Lo
-._.. I `7o Funeral Charges_.—.---_. Total, $
rice of Casket or Coffin . . . .
Metallic Lining . . . .
Outside Box . . . . .
Grave Vault
Burial Robe
Burial Slippers and Hose
imbalmirrgBody (with .... ............... ___....... _.__ Fluid
Vashing and Dressing .
ihaving . . . . . . . .
'feeping Body on Ice . . . . .
Disinfecting Rooms
Use of Catafalque and Drapery . . .
Folding Chairs . . . .
" Candelabrum . . . . .
Candles . . . . . . . .
Gloves . .
Crape . . . . . . . . .
Number of Carriages _......__.___._.... ®$..................
Hearse. . . . . . • .
Wagon Deliveries._..... _....... __ ..._� ...........
Death NPtice; in,64,.�� ` e spapers .
(\ames of Sawsptpen)
Flowers
Outlay for Lot
Opening Grave .
Lining Grave .
Shipping Charges, prepaid
IRemoval Charges
Cremation Charges
Total Footing of Bill
By Amount Paid in Advance
Balance
...... ...... _....
...............
...... — ---
-.........
-------- - —
,.� -� -
tf1 - _ _�_ .. --
i- _, - _... -__
.. .. .__._. .._I ._ ,oY I900.
Com •--....�`_. �� 54 Louts,Tfa. !n tl ea
Wiw '..-� comply''/ b F. J. FEINEAfAN,
sL Louts, 1'0., In the year moo.
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