HomeMy WebLinkAboutCemBK1901to1907pg46,47-0035■ )
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tr-4UNERAL,46
-- _ /n + �FUNERAL �ECORD �
Date.._o--- _ ...
ivYana Name of tics Deceased
Yana of tics Deceased -
Charge to
_____----- -- -- -- Price of Casket or Coffin a to ----
Order given by _ _ _ __-._..--
._._�--- Metallic Lining � Order given by •----�-'-'--'--'- ��- P
Sow secured --- �- Outside Box flow secured _
Date of Funeral=0p / ., Grave Vault-J�I�-Ly l
Date of Funeral
Funeral Services at ._ Burial Robe
Funeral Services _---- -``--" Burial Slippers and Hose Funeral Services at
Time of o Funeral Services ��.1� -
__L_.__---=-- EmbalmingBody(with........._._..._........ Raid) Time of
_�9_..__.._...._•-- 1
Clergyman Washing and Dressing Clergyman
Certifying Physieifin__._---- --- "` Shaving
. Certifying Physician _____.._....-.---._—.___._.._._....._--. • _ I
Number of Burial Cerli Bate-..____ -- - - Keeping Body on Ice
isinfecting Rooms Number of Burial Certi ea e_. t
Cause of Deatic _ _...._.._..___......
' Death l� _�... _............... ......._. ,
�_� Use of Catafalque and 4,�pery Cause of �{�- `
Date of Deatic Folding Chairs Date of Death
( r
Occupation of the Decease cL Candelabrum
p Occupation of the D_e�ce�ased.
Single or Harried —`Religion Candles Ii Single or Married_..y[`L elision
.gged Pears, Months, ----Days. Gloves jg t Days.
Crape !! d sed_. ••--Years, ... lQ• Jllonths, _..... __/_,. _ /Q
Body to be shipped to
Number of Carriages ................................. G $ _ b ,$ody to be shipped —
Size and Style of Casket or Cofn_ Hearse .
Size and Style of Casket or Coffin ---•----
WagonDeliveries ........................ . ........................
Manufactured by_.��_�_
Death Notices in...__ ......... __... .... Newspapers .
Metallic Lining
Outside Box _
Interment at
-#•. _ d""-`_�""o`r_'—Cemetery.
Lot or Grave No. 11— .__.__.. Section No•_
(Diagram of Mt.l ___.__.......
Designate all Graves in space for this Funentl Lot with numbers (1 2 3 4,
Desi with a cross (q.), ' ' , eto•), and mark
gnate Place for Monument
UsesPace to the rig' of um with a small
Diagram for the.. square(13) -
Meg of thburied to Lot.
To Faa,I C/,a,g I
Al t
............................... _.................... ....
_
( Names of Newspapers)
Flowers
Outlay for Lot
Opening Grave
Lining Grave . . . . . . .
Shipping Charges, prepaid .
Removal Charges
Cremation Charges .
Total Footing of Bill
By Amount Paid in Advance
Balance
Entered into Ledger, page ............................. orbelow,
.lTaraufactured by-__.....--------- -
,dletallic Lining_-------- — -----
Outside Box _
Interment at.zf� �` -- emetery.
Lot or Grave No,—.-6_.-_•.•-•-Stotion No•
1 ....
s.
3. ._...
4•.._.........—_._.-- -•-
—� (Diagram of Lot.)
Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mar
space for this Funeral with a cross W.
-� Designate place for Monument with a small square (G) -
Use space to the rightof Diagram for the names of those buried inLo
...... .... By Cash.-...---
...t
__._..__._____._
•ice of Casket or Coffin
$
Metallic Lining . .
. I _.__............. .
Outside Box , . •
• _._ __....
Grave Vault . . .
. . _......-------_._
04 Burial Robe . .
. . ------...._...
04 Burial Slippers and Hose
?mbalmingBody (with...._. ........ ... _..._.-
_.__ F7aid )*I
washing and Dressing . . .
• ---
;having . . . .
.
%ping Body on Ice .
_._..
Disinfecting Rooms
Use of Catafalque and Drapery
-- - -
" Folding Chairs . • •
--- -
Ji Candelabrum • • •
--- - �-'-
Candles . . . . . .
.
Gloves . . .
. ......
Crape• • '
Number of Carriages_.._...__._._...........
'
• ,
Hearse. • • • • . '
Wagon Deliveries....__'_'.''•_...II .Death Nptices in_.ld lr ewspapers
.Y....•.---l.j,h," of NeRapiper+)
Flowers
Outlay for Lot
Opening Grave
Lining Grave • • -
Shipping Charges, prepaid
IRemoval Charges •
Cremation Charges
Total Footing of Bill
LAmountPaid in Advaricealanceorbelow.1Ledger,Page
II•-..._.._ -I - --
11ta, /n the Yvur 1900.
Compiled by F. J. FEINEPfAN, SL Louts,
CemAf!-......_........ _._.._.. . _..
� � P.
J• FEINEMAN, .. ---•—
SL Louts, 14
c, 143 the year 1000.