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® OIL FUNERAL
/ F, - Date..-. RFCORD OF FUNERAL.
Date
of the Deceased f
Name f��.,,,� ���
-- _-_--_ Warne of the Deceased_��.LL'-1_!��--
Charge to
__-----------_'- to..-•_ ---
en by Price of Casket or Coffin \ Charge
---- --- - --- - ---
order liver; if Metallic Lining "� order>iven by._.------_-_---..._.............._...w_
Sow secured— Price of Casket or Coffin —
Outside Box How Secured - .. Metallic Lining -- --
Date of Funeral if Grave Vault . , - _.�._c} ..
` - -'-- Date of Funeral f- Outside Box __._.._. _...
Funeral Services at Burial Robe _._
Time of Funer Services
— Burial Slippers and Hose Funeral Services at __ ... �y Burial Robe I -
EmbalmingBody(with...................»....__.__, Time of Funeral ervices ..�_ •� Burial Slippers and Hose
-._...-.-_.....- ..... Fluid)
Clergn Washing and Dressing __-_ _..............__.._._...... .... ......
• Clergyma - ._ _ ._
-� E
"' n Dressing
.
mbalmingBody (with
Colifying PlaysicShaving . . pla sician Washing and Dr ins -
I
' Cortifytn� y
- - Keeping Body on Ice �.-Shaving
Number of Burial Certifleat Keeping Body on Ice - -
Came of Death- - - Disinfecting Rooms
Nuniber of Burial Certi Bate_..._._.. —..._— _ ,
/ ..-.�.�-!�!.-u.1............. Disinfecting Rooms
_ Use of Catafalque and Drapery Cause of Death..__ _ -
Date of Death ,, Use of Catafalque and Drapery ---
Folding Chairs • _ Death �-
• Date of Folding Chairs
Occupation of the Deceased " Candelabrum - a the Deceased _ Candelabrum -- -
Occupation ) a
/, / I ..
SinfleorMarriedn�l Relijion,L�L� Candles .Relifion.t o 9 andles
. � Single or ,J{Tarried.��J��� .
J! ed �(` Years, �Q _ Months, Gloves . ................. Gloves . . . __.._
f -N— _.Days. e d /f Years,.._.. ......._Months �- Days. _.__.
Crape q'e ..._ -- Crape
Body to be shipped to
Number of Carriages, ........... _................... ++ $ Body to be shipped to -__--'•---- _-......_.__ Number of Carriages..........__._..._.... a
Size and Style of Casket or Coffin Hearse .
• Size and Style of Casket or Cofj'in___......�-_--.---_-_. Hearse .
Wagon Deliveries..-... Wagon Deliveries__.._..... News a ers _.._.._._ ..... _.........
- -
Death No 'ces in.»�erwspapers - Notices m`mes P P _
Manufactured by t l
liarzufactured by-••---.._. _.__-----._--__-__-__ _._.j_.. ..._....._..._.__......_...._._.._._..--
n e 1
(Na t N weDiDen
MetaUie Lining (Names of Newspapers) Metallic Lining ---- -- Flowers • • • • • '
Flowers Outlay for Lot • • • • • '
Outside Box Outlay for Lot - Outside Box .._ Opening Grave
Interment at-
,� t Opening Grave - Interment at _ __.Cemetery. Lining Grave . . . . • • _ _._.
-,.0 meterU• l P prepaid
LotorGrave No. Lining Grave _ Lot o�- Qi•erse No._._� ----Section No•____- Shipping Charges, P P
-�--QSection o -----ova_.__.. _.....
att� Shipping Charges, prepaid RemCharges
-- ...E . �•i�� -_-
Removal Charges - Cremation Charges
Cremation Charges .
8. ____
4. - ---._..... --.................... _......._..
- ..
s.
Total Footing of Bill $�
(Diagruo.f Lot.) /. 'L L. .Y•,
Designate all Graree is Lot �� By Amount Pa;d in Advance I —
apace for this Fuae ti<'ith numbers 1 ral with a (, 2, 3, 9, arc.), and murk
Designate place for 1lfonucroes ({ ),
U�"'Lee to the right of D aentol fora
small square (p), j Balance
Bfamforthenames Ofthose buriedinLot.l below,
�— ErfteredintoLed er a e..............................orbelo
g ,P 9
- rlio Fungal
- �'a�e$ - Total,
I ;
...........__.....__......._.».._.... ^' -mil
CoMPf1
6yF. d F t ; - ....... I ..... _».»... �._.._..._-.-...-._.._...
fINEMAN. SL Louts,
Ma, In the Year 1900.
_ ._.._.___... By Cash..___.._...____.....---•---" �
..........................
$ _-
4.
G. $
..._..__n o-_.._...._.._.._.__._..._..._... Total Footing of Bill
f1...... y� �` `'"- By Amount Pa:-d in Advance
I l
(Diagram of Lot.) Balance '
Designate all Graves in Lot with numbers (1, 2,3, •1, etc.), and mark
apace for this Funeral with a cross (•f•)• or below.
Designate place for Monument with a small square (a)•ag-- -
Use space to the right of Diagram for the names of those buried inLot. Entered lute Ledger, Page.
............
_----
1
tlYcur 1900.
cornpffed by F- d. FEINEMAN, Sr- LouLq, Afa, Ir+ :e