HomeMy WebLinkAboutCemBK1901to1907pg34,35-0029� ✓ '" FUNFPALO
31 RECORD 0 RECORD OE �UNERAL.
Date..... /
Date.._ .....0-.rl.__J 1....- ..
No.
Name of the Deceased _ ___ - ------------ __
---- --��� Name of the Deceased_
Charge to .. ....__
-` -" I Price of Casket or Coffin Charge to -
Order given by -------._ - $ given by -
MetallicLinin9 order ..__-.__---_..__.___.__._-_..._....... .... - -_--^
• Price of Casket or Coffin $ --
How secured- Outside Box secured _.-• ---- �• -
- -• Ilow ; � Metallic Lining -
Date of Funeral , Grave Vault Funeral_ ---- - - Outside Box - ---
at - Burial Robe Date of ., ;
Funeral Servie ,. Grave Vault .
a __-_...___ Funeral Service at �Ll�_..��:'1.-�'.�.lp_�e'� ..- _-..
Burial Slippers and Hose Burial Robe
Funeral Service . Pp o Funeral Servi s - ..1--_.-.--•...-.-
Time of Time f - Burial Slippers and Hose _.__.__. _......... .
-- - EmbalmingBody (<with._......._.__.._... .......... F71dd) _.. _ _ 1
Clergyman ,. -.-- _-- -.__ - EmbalmingBody(with__........__.....___.................F7ui _...... —._
A Washing and Dressing Clergy»tan ,
1 , Washing and Dressing .
G,rlifying Playsician pU Shaving s Physician( _.___.._.......__.__ • • • • _
Cartifyins shaving .
Number of Burial Ce ifleate-- Keeping Body on Ice Burial Cert' .sate...._.......... _..____.._..___. _
' .-- Disinfecting Rooms Number of 1 Keeping Body on Ice
Cause of Death - -.� Disinfecting Rooms - ....._
Use of Catafalque and Drapery Cause of Death g -
Date of Deathi Use of Catafalque and Drapery . - - --
Folding Chairs Data of Death,-- Folding Chairs
Oieuilie Deceased Candelabrum CanCandelabrum --
• anon of t e Deceased - �� C d labrum
� Oacup /Jl
Single or Married, Religion ttleCandles eli6ionV _... _ Candles • • : : . . . ti -
Single or Married
Gloves Gloves .
�Iged_Yiars,. -. Jllonths, .��_Days. - Years, .......3._.._ Months, _. ...................Days. _ --
Crape Aged E- Crape . . .
Body to be shipped to ...........__
Number of Carriages .__............__... •��$............... Body to be sliippedto �---------_--- Number of Carriages....._......_..._.........0$................_--- .__.
Size and Style of Casket or Coffin- Hearse . . • •
Size and Style of Casket or Coffin _ Hearse .
W Wagon Deliveries _................ ___....
t agon e rverres........._........... _.................................... -----
Death N rites in. .. I. ewsPal
Manufactured br Death Notices in ...................._ ..... Newspapers _ t
f _y._
,Ma1LLifCGCtiiTed by_.....�_..._._..---.._-----------•—"— tSames of SeNsvavenl
wnfQewapaPers) .---- Flowers '
Metallic Lining - Flowers (Yas u[ metallicLining% •
Outlay for Lot
Outside Box
Outlay for Lot Outside Box - Opening Grave
' /�f , Cemetery.
Interment at Opening Grave Interment at U?�-d u I f _ Lining Grave .
.__Cemetery,
Lining Grave - Shipping Charges, prepaid
Lot or••8rlit Ae9,� Section No•_ _ Lot or -gave No. _...J......_.....___Section No•:-�---- Re nova! Charges
AP
t Shipping Charges, prepaid 1
iµf.....!.,.. ... .
!J Removal Charges -" / Cremation Charges .
I f . ........_ .. ._. __ _._.__.._. _....
8. _---_.................... ..........................
4 — __—.._---_................. ............. ___ ..._
e' Total Footing of Bill
1DtePIM Of all Graves. By Amount Paid in Advance
Designate all Graves in Lot with numbers (1, 2, 3, 4 etc.)
apace for this pltneml with a cross (d.).
Designate place for Sionument ,and mark Balance
Useepace to the right ofDia with a small (f7)• •
Gram for the names of hose
bun -_-C edinLot. Entered into Ledger, page.
- `ro Funeral cha,yes
By
. - ........
�omPlled �,,!INEM ...___.._..
AN, SL Louts,
Mo., In the Year 1900.
3.
4.
G.
..............._. _..._._.._.._.__.__._._. ing of Bill Total
moFounot
a By At Paid in Advance
(nlagram of Lut.) Balance '
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark
apace for this Funeral with a cross (d•)• _ _. or below.
Designate place for Monument with a small square (G)• e
Usespace to the rightof Diagram for the names of those buriedinLot. Entered into Le gar. Page
_ —
_..___ 19G-5_._.
IBy Cash
ges._._..._J.._._ Tolat;, $ I.-....._..._..Io Funeral Car.
/f i ........
._.-..._._............
...
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.. _................._ ..._.._ ........ ._
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_._...._.___..__...._........_.
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J, FEf NEh1AN. SC Louis. Ata, !n the year 190
Cor„plfcd by F.