HomeMy WebLinkAboutCemBK1901to1907pg92,93-0058u
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RD OF FUNERAL, 1
-
90)
/ REcopD OF FUNERAL
fL...l��:I.Ae-:l.:w�,�(
Date.---•-A(=�••°.��.�.�✓_
X0.� \. No. /
eeeased --- - - _ _
Nance of the D --- `"-�� �yrarrie othe Deceased_/0
--�\. f --
Charge to --- --`"' ~ price of Casket or Coffin Char-fe to-----'- - -- -.
Order given by-------�_- •• Metallic Lining 1 -- ---- -
• Order given by..__ -.
�` (� �t •' Outside Box Price of Casket or Coffin $-------•- ----
$ow secured- secured_..__. - - '• Metallic Lining
� ,.r/ flow
J Grave Vault (n
Funeral �' r Funeral_ �L(•---tom ___._Jim-._.- •• Outside Box ------ -_--
Date of - --- .. Burial Robe Date of _....___
Grave Vault I ..
Funeral Services at Burial Slippers and Hose Burial Robe -
ires -'��" --- -. Funeral Services at _ .!
Time of Funeral Sere ' _ E'mbalmingBody (•with .......................____._._. Time of Funeral Services ..Il....T( ems_-- ------ -.... . .• Bcrrial Slippers and Hose
_ -
Flui
Ckrgyman 1 Washing and Dressing_ .... _ __..._....__C. % ...._ E and Dressinge • ue _.--
...... Clergyman f� mbalmi r witl
r gBody
Staving ° C ... E Washing a
PTc sician g _
C9rlifying y Cortifyin� pTiysician..
Keeping Body on Ice Shaving
Number of Burial CertifEeate_---- Keeping Body on Ice - -
_._
- .......
Disinfecting Rooms Number of Burial Certrjleate...__._....__.. ..-__.- • •.---
Cause of Death _ Use of Catafalque and Drapery C(luse of Death, " -- Disinfecting Rooms _.... --'
_ Use of Catafalque and Drapery
Date of Death__ Folding Chabs Date of Death-P � --- •• Folding Cbairs . . . . the Deceased " Candelabrum Occupation of the Deceasedohu------- J• Candelabrum _._.._
Occupation of ,,�� ``nn _ _ _• • __-
m,lfarried�llReli;'ion Candles f�+� • • '
Singly Gloves Single or I�arraed..c�J..-. .-Relhlion Kr<y- Candles
( Days
Glov
es
---Days. ed......Y
AgeCrape ........ears, .lontls,.._.
- Months 6
Crape . . .
Body to be shipped to Number of Carriages _..........__._.... _ O$....... -
Number of Carriages _._ ......... @ $.....- Body to be shipped to_._-------------�"
Size anal Style of Casket or Cod fl►t
Hearse . Size and Style of Casket or Coffin... ....... _ - _ -.-- Hearse.
Wagon Deliveries........... ....
....... ......... ........ ...... -._-- Wagon Deliveries .......... __.... _._.________._...__ ___...._...._._._....
_ .. __..._.._._.____._._.-------- --- 'Deatic Notices in ............._.-...---- ewspapers .
---------
Death Notices in..................__....Newspapers .--._._._..__-•-_ - -- - -
Manufactured by_-_._ Manufactured by-----••— -- (Names oraew..... c.1 --
_ _Names.........Flowers
(xameyoixew9vaper9l.. e}tatallic Lining ----'-'--J '
Metallic Lining Flowers Outlay for Lot --'-" - - -
' ` Outla or Lot Outside Box ._.._..--- ^ -----.__.- --.--_
. Opening Grave .
Outside Boa __ Y f n Cemetery. ----.-....
Opening Grave Iriterrnent at.. 1. - •• It— '_.- Lining Grave
Interment at —Cemetery. /Shipping Charges, prepaid
-
Zincng Grave Lvtar-9ra-ve�o.eaa.� .G�..E�See n No•-_.._.------__.._._
Lot er6rave No.. � ` _. __. pp g y r e aid Removal Cbarges • • • ' - -
�' .. Section No•_L_ - Shipping Char• es, prepaid p 1.
1• Removal Charges , �1 s 3
�,, t N -""'"' Cremation Charges -
z, Cremation Charges
�-
---- -
4. 8•
- Total Footing of Bill-
8. ts.
---_.._.___...---•___-•--._-'.............. A ount Paid it, Advance__ ----
a.
(nlagnm of let.)
Designate all Grates in Lot with numbers (1, 2, 3, 4, etc,),
apace for this Funeral with a cross (•p)and mark
.
Designate place for Monument with Use apace to a small square (p),
the rightof Diagram for the names of those buried in Lot.
Total, $
w
Total Footing of Bill • • , - •
(nlagram of Lot.) Balance
By Amount Paid in Advance
Designate all Graces in Lot with numbers (1, 2, 3, 4, etc.), and mark
space for this Funeral with a cross (• . , _. or below.
• Designate place for Monument with a small square (0)• e. � — --�- --
Balance Use space to the righted Diagram for the names of those buried inLot. Entered into Ledger, Page .. -- _—
or below- _ -- -- $
Entered into Ledger, page..........._..__..... -.. `In F neral Cary s_ - _ Tola� .......... _-. ...
Cash •---_._.... _ —nrf�
a .yc%i1.... 1lP .`
D_ I... ...... _........ _............. ._._..._._
_.... ...............
............ . ....
b F. ✓• F-INEMAN. St. Louis, Ala, In tLu year 1900.
Compiled y
... i
Compiled by j,
' y FFINEMAN, St- Lolls, Mo., in file year 1900•