HomeMy WebLinkAboutCemBK1901to1907pg86,87-0055RC,c,ORD OF FuNERAL,
the Deceased 4�� �-
Namc of ____------ -
charffe
Order given by
How secured—
Date of Funeral
Funeral Services at ��' /%!I!!•
Time of Funeral Services
G,rtifying t'lays&"'Ww rg -
U
Number of Burial C rtiftcate_,-
.
Cause of Death `
Leal -
Date of Death ,
Occupation of the Deceased
Singlen'jiftarrie d�Religion.Ageyears, -: .Months, _ Days.
Body to be skipped to -
Size and Style of Casket or Coffin
,Manufactured by
Metallic Lining_
Outside Box
Interment at
Iw4ls-0rave-No. _(
(Diagram of Lot.)
Designate all Graves 1n Lot with numbers (1, 2, 3, 4, etc,), and mar
space for this Funeral with a cross (q.),
Designate Place for Monument with a small square
Use space to the right of Diagram for the names of those buried inLo
�_
Total, $ I _- , __
0
RECORD OF FUNERAL.
Date.._
Deceased__-� N `
(ante of the
Price of Casket or Coffin wharge
Metallic Lining Irder given by -- "��-�r» Fp,
it Outside Box low secured
41 Grave Vault Funeral_
)ate of /
!' Burial Robe . . ?li �.+.,._.__...._._
' �unerat Services at �-• -
/! Burial Slippers and Hose
g y ( 1e of Funeral Services ._..-ld--••-------
Embalmfn Bod (with ............................_-.---Ffui�� �`n s, ��p.._....._....- ...... .... . 1
Washing and Dressing "lergyman /�AQ
Shaving ang playsician �J_:.._....,1 .Jc - ...._........._.
„rtify
Keeping Body on Ice TPuntber of Burial -
Disinfecting Rooms 1 .
Death_. a..._..._........._._
Use of Catafalque and Drapery WOUSe of
Folding Chairs pate of Death = --
�l
Candelabrum the Deceased
7ccupation of
Candles I s
Single or Married_. ll-eli ion
Gloves Years, ✓1lonths, ............_-_.._Days.
....................
Crape
Number of Carriages-......... ............... .... � $... -_- Body to be Shipped to—_---- .----------'-`---
Hearse . • • Si,e, and Style of Casket or 00#171._ ----
Wagon Deliveries .................._... --- --- — —
Death Notices in.__........._._.._.Newspapers .
;1lanufactured by_......_
.�»_....................................................._ __ _
(Names of Newspapers) Metallic Linins_------�•-
Flowers
Outlay for Lot 9utside Box ----///
Cemetery -
Opening Grave Interment at'
Lining Grave Lot or Grave No.�
_.......... _Section No• ----
Shipping Charges, prepaid 1
Removal Charges •
Cremation Charges •
4.
.........._.........._ - --i ..............._
Total Footing of Bill
jBy Amount Pa>d in Advance
ice of Casket or Coffin $I-- —
it Metallic Lining -- -
it Outside Box • • • • • - - -
Grave Vault . . ....... __..._
Burial Robe ,
Burial Slippers and Hose
?mbalmingBody (with .......... .... .... ..... .................... fluid) .—_..... __.._
Vashing and Dressing -
)having . • • • • • '
Ceeping Body on Ice . - --
Disinfecting Rooms ,
Use of Catafalque and Drapery --
Folding Chairs .
it Candelabrum . • • • • -
Candles • • • • • ' ' -
Gloves • • • • • ' •
Crape , • ' ' • _
Number of Carriages ..... ........... ...........
@ $_................... ...._....... __.
Hearse .
Wagon Deliveries
Death Notices in .......... ......... _Newspapers
(NS,aea of Neaspapen )
Flo¢vers • • •
Outlay for Lot
Opening Grave
Lining Grave
Shipping Charges, prepaid
IRemoval Charges -
Cremation Changes
(Diagram of Lot.) 0 3 .1, etc.), and mark
(1
Total Footing of Bill
By Amount Pad in Advance FiT
Balance • • • '
Dba esignate all Graves in Lot with num er , -, .
space for this Funeral with a cross (•I•)•
Desi age. _........._..._.._.. or be Dill.
gnate place for Monument with a small square (G) • Use space to therightofDiagramforthenamesofthoseburiedinLot. FttteredintoLedger�p---
Entered into Ledger, page ..... .... ...... ._..__ _..... ..........I —...__ `fo Funerat Charges..._.---....... Total, $ i............
.... _.I I ..........._..
Balance
Cash.__.•••_.--_
........
_...... ....
I-- -
..
I /I complied by J. FEtNEM1IAN. St- Louts, hfa,
F.
Co i �•..... �..__._ ..—u....a..�.._.
mpp�y by F.
J• FE/NEMAN, SL LouIS, Mo.. In the Year 1000.