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HomeMy WebLinkAboutCemBK1901to1907pg48,49-0036M } /: i Na)ne of the Decea Charge to---r Order given by --- How seeured,- Date of Funeral Funeral Servicesla, Tine of Funeral ?E R RI) VUNFPAL. EGO -_ Date ............. ��.. ( C<rtifying Ynysw,w, — Nuniber of Burial Cortijleat(_• - ---- 1 Cause of Death Date of Death Occupation of the DeeeasedVh"'-_//// Single or Married iT ReliffionGll� Agcd j-Yeara, _1� Months Body to be shipped t Si.z . afut Style of Casket or Co f n RECORD OF FUNERAL Name o the Deceased-f�i- v1.a�UG __.... price of Casket or Coffin Charg e FP Metallic Lining S Order liven by •---------------_-----------............._- _ Outside Box Lrow secured-------- �` Grave Vault k'fcneral_- _ �-�-- ye " Burial Robe • Date of ' Funeral Services at ._ K,���-- „ Burial Slippers and Hose ... _ rt[ r...... Time of Funeral Services . __... EmbalmingBody(•with......................... ........... _....... Fluid)-��t`r. v...._...__...._..... ...... ... ... 1 Washing and Dressing Clergyman Shaving s PTi sician...---......................_.._......_........._................_.- C.rtifyins y Keeping Body on Ice . Burial Certificate ............._..._._—..------ ._._.- Number of 0-1Disinfecting Rooms Deatli""'`+- _. Use of Catafalque and Drapery Cause of it `� Folding Chairs . Date of Death T- to Candelabrumypati e ; e f if, Candles mil&-nr_��'"Y Relis%fys. Gloves `Jllonths, ...am Days. wed-----........_...----Y`ezzrsy ..... j._......... Manufactured by ---- Metallic Lining Outside Box Interment at-��Cemetery. Lot or Grave,A`6.1 � .___..Section No• t^- 3. 4. r Crape . . . • • • Number of Carriages _......._......... .......__ G $................. Body to be shipped to.-------------- Hearse . . . . . Size and Style of Casket or Coffin___.........___._.....__...---_.-_.. WagonDeliveries ....................._- ..... ................... ----- ----—...---- Death Notices in..__......_.. -.._Newspapers . dltirzufactured by_.-.-----------------.—____._ ............. (Names of Newspapers) •diet allic Lining ---- — — Rowers - Outlay for Lot -- Outside Box ._.. "' Interment at_C•.-.Cemetery. Opening Grave ' ((�� ! Lining Grave Lot or Grave No.___[._.__............_Section No• -- -- -- Shipping Charges, prepaid i. ._......._.'i..... -•-•-.. i� Removal Charges • J ° ' z. Cremation Charges • 3, .......... 4. ._ __....._._.__._..... _—.... _. ..... —_........... ... ......... ...... .................._.._...._.._... _............... _--- - -- cs. (Dlagnm of Lot.) Designate all Graree i'l Lot with'lumbers (1, 2, 3, 4, etc.), and mark space for this Funeral with a cross (.p)• i Designate place for Monument with a small square (13), Usespace to the rightotDiagram for the names of those buried in Lot. — I40 Funeral charges______ Total, _ — Total Footing of Bill . By Amount Pa;d in Advance Balance S... ...... _... ______._.._ (Diagram of Lot.) and mat Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), space for this Funeral with a cross (•A)• Designate place for Monument with a small fro Use space to the right of Diagram for the nameess Oof those so buried in Lc Entered into Ledger, page_= r beloi _I -._____._I_ _-• 1By Cash ...... - ._.. - -_ Co,nanOd ey p. J. FE/NEMgIy, gL Louts, Ma, In Uto year 1000. ___L....___ I`fo Funeral Charges -----Total, $ ice of Casket or Coffin $II Metallic Lining . . . „ _........_ ....._...._ i •' Outside Box . . . . . Grave Vault I -- Burial Robe , . ;� _.._...._ .__..... Burial Slippers and Hose I :mbalmingBody (•with _.._... ............ ......... ..... ..._. Fluid) mashing and Dressing . . • . 'having - . . . . . . . Ceeping Body on Ice . I - -- Disinfecting Rooms . Use of Catafalque and Drapery -- - -- it Folding Chairs . . . . . -------- " Candelabrum . . . . ._. _ Candles • • • • • ' Gloves . . . . . . . (..- ... _._..._ Crape. . . . _ �$...._............... --- Number of Carriages _..__ ........._..... •� Hearse . . . . . . Wagon Deliveries ............._.. __....._....---._....._...._____ ........._. - -- Death Notices in_.._...._.............. Newspapers ................. — (Names of . ewspaprrs _— Flowers • • • • • • - - ......__...-- —•- Outlafor Lot Openiyng Grave - - Lining Grave --._.._.. -- Shipping Charges, prepaid IRemoval Charges . - Cremation Charges . . _I - Total Footing of Bill . • • ' ' 'rI By Amount Paid in Advance e Balance t. Entered into Ledger, Page or below• .-_-...........___-. jBy Cash-- -- — -- $ ......... - ....... .......... - compiled by F. J. FEINEAIAN. St. Louts. Afa, to the year t9oo.