Loading...
HomeMy WebLinkAboutCemBK1901to1907pg88,89-005688 RE Date.._._.f•rim RECORD OF FUNERAL. Deceased of tTie Deceased _• -- ,brame of the nranbe __— Charge—...>>i _ `_ ( liaree t0�- -- — -- price of Casket or Coffin ._-----_-.. � liven bye- " MdallicLining tsiven by ----__.. _____ Order g order } Price of Casket or Coffin i - �� " Outside Box llour secured _--- - ., Metallic Lining . . . . I HOW secured _ _ .. Grave Vault _ --�Pe Funeral Faneral Outside Box Date of Burial Robe Date of — __ •• Grave Vault • Funeral Services at _�il(u� - - Services at Burial Robe . • Funeral Burial Slippers and Hose l S Funeral Services ��---u'`-`'""— ._.._. _ —...._ . ... `• Burial tippers and Hose . Time of EmbalmingBody(with..........................._..........._.u;�) Time of Funera Ser ices •�-----._.............._.._......__ EmbalmingBody(euith................ ____._.._.__...._F7uid)• Olergyrnan '- Washing and Dressing Clerfryman Lan /G n Dressing . . . . . stcian - _.._.. Shaving Certifying Physic' �.�__ Shaving a • . . d Dr ing CIrtifying Phy Keeping Body on Ice . Burial Certi cate..._......__ ---- --- Number of Burial Certificate Number of Keeping Body on Ice ,) v .__ Disinfecting Rooms ............_....._.._...__...----- Disinfecting Rooms Death - ` Deatic._.._-_- Cause of / Use of Catafalque and Drapery cause of j____Day8. Use of Cata falque and Drapery Date of Death Folding Chairs Date of Death. •� Folding Chairs D " Candelabrum the Deceased- �.. Candelabrum Occupation of the Deceased Occupation of t Religion �:' Candles Single or Married., Candles Singly or.Married� Gloves . . . . . . . Dar s Gloves ,Months, ...... AQed2-Fears, �/— months, _LL__ _ d ' Crape . . . Aged....-_/__ _years, _.n......-•Crape . Number of Carriages...._.._._...._ ............. On Body Body to be shipped to — NurnberofCarriages.._.—..._...._....©$.......---...._.....Body to be shipped to HearseHearse . Size and Style of Casket or Coffin.____...__Size and Style of Casket or Co f fin__._..___—__---- Wagon Deliveries _.........__.......Wagon Deliveries ..................... _........._......._.___ _. - - Death Notices in....____.__- eevspapers Death Notices in_.........................Newspapers . __Manufactured by ......._.._..—...___liarcfaetured 0e,o New . ) --'- ' ' (Na f v&veo ................ (Names of Newspapers) ,ltiletalliC Lining ---��� Rowers Metallic Lining Flowers - Outlay for Lot Outside Box O enin Grave Outside Box Outlay for Lot P g Opening Grave Interment at 1. Cemetery. Lining Grave 4JI Interment at Cemetery. �G�` Shipping Charges, prepaid Lining Grave Lot or Grave-Nv. _�........... .Section No• - - PP g Lot or Grave Ai dirSeotion No•_— Shipping Charges. prepaid 1 Removal Charges 6 ._........_..... _. _.__. • _��� 1/ •-•� 13 � __...._._._____...__. Cremation Charges . 1. Removal Charges z, L. Cremation Charges . --.--- -- - — S. _.__ ___..._.—.._...... —�. ... 4. 8. �__�.�—,- ••--•-----'-�" Total Footing of Bill 8. a By Amount Pa;d it, Advance _.... --------____--._—�_-•--.._.__... ' Imo_ -- .___..._._ t 8• Total Footing of Bill (Ul¢Fr¢m ofLot.) I Balance (Diagram of Lot.) By Amount Paid fit Advance Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mar Designate all Graves in Lot with numbers (1, 2, 3, 4, etc.), and mark I space for this Funeral with a cross (d )• space for this Funeral with a cross Designate place for Monument with a small square (0)• Deai (1)• Bal arICe ('se space to the right of Diagram for the names of those buried in Lot. gnato place for �fonume¢t n•ith a small square Use space to the ri or bel0' ghtof Diagram for the names of th se buried in Lot. — Entered ir:toLedgef,page' ................ r a I:...�1_4o Fug t Charges—._.—...-T�a i......_. T, Entered into Ledger, page ....._..._..._.._.__. or _..... . - r . F. If. FEINEAfA N, SL Louis, A10.. Lo:nPlled by to the 3'esr 790 . i __._._-_mil-_ -•--_.- .............. .., .. ComPlled by F' J• FE/NEMq N, SL Louis, A: o., 111 t1;a Ycjr 7900•