Loading...
HomeMy WebLinkAboutCemBK1901to1907pg92,93-0059t D OF FU R E GO Date......... N Name of the Deceased_--=D"' _ i Charge Order given by Jf Sow secured_-�//�`,�•i_d= __ _ _ Date of Funeral l , Funeral Services at f Funer Servic _sup Time o Clergyman G.rlifying Phys, ianAllF= Number of Burial Certaflcate__---- Cause of n Date of Death Occupation of the Deceased l IReli ion74� 'L� 'Sin.¢le or ,,lfarried ^ iLo� s zir Months, _I- —Days. Body to be shipped to Size and Style of Casket or Collin_ Manufactured by___._....__.._... --- Metallic Lining _..... Outside Box Interment at lam —Cemetery. Lot or Grave No.-63A�e­.__-Section NO. L -- 8. 4. s. ----.- (Diagram of Lot.) Designate all Graves In Lot with numbers (1, 2, 3, 4, etc.), and mark Space for this Funeral with a cross (d ), Designate pl Usace for Monument with a small square (13). o space to the rightof Diagram for the names of those buried in Lot. Funeral Chagas_ ---__Total, 'rice of Casket or Coffin fin " Metallic Lining a Outside Box . 41 Grave Vault 41 Burial Robe Burial Slippers and Hose , T'mbalmingBody (with ................................... P(uid) Washing and Dressing . Shaving Keeping Body on Ice Disinfecting Rooms Use of Catafalque and Drapery . 40 Folding Chairs , " Candelabrum , Candles Gloves Crape . Number of Carriages. _......._........... __ ........ Hearse • Wagon Deliveries ...................... _................. ... _.----._ Death Notices in..........................Newspapers . (Names ut Newspapers) Flowers • • • • • ' Outlay for Lot Opening Grave Lining Grave ShippingtCharges, prepaid Removal Charges RECORD OE FUNERAL. /.(-.__..._..__._....19% �1.-- Name of the Deceased_ Charge --- order given by FP $ow secured-------- --J , l- 04-.._....... . — Date of 1+'uneral -- -- Funeral Services at ... of Funeral Servie s ...i� ►� - Tinge Clergyman Certifyin£Ph' sician:-E1J�' - - .-_--.-....___..._-.............. ...-_ i , Number of Burial C�e-/rtificate...... Cause of Death -_..__._ Date of Death,-�� �.__.._._._......_ 1��� Occupation of rigs Deceased .�1 Single or •Married.`51WIV i+-Reli6ion r Years, __.LP29-...Months, ...............-Days. Body to be Size and Style of Casket or Coffin ..... ------------------ .......... ----- -. U(Vtufactured by_.._.-..__ _.._...._..._-_ ,Afef allic Lining ___---------- ---- - Outside Box - Interment at_`L1�E �/[X* �1 •...._..__Cemetery. Lot or Grave No, _4. ......... __Section No•_l�uP-.---- 1. ......... Cremation Charges s - lx. Total Footing of Bill By Amount Paid in Advance Balance a ii. 1 Entered into Ledger, page .............. 4. ......_... ( I • (Diagram of Lot.) Designate all Graves in Lot with numbera (1, 2, 3, •1, etc.), and mw space for this Funeral with it cross (d•)• Designate place for -Monument with a small squaro ([se buried in Use space to the right of Diagram for the names of those low• = — -- if ! n I-.._....I`fo Funeral Charges------ Total. $IL..............._I_... ' __..... _...... ice of Casket or Coffin p _.....-... ....__.._ '• Metallic Lining - - Outside Box . . . Grave Vault . . . _-...... ..-_- Burial Robe . . . . ...... .......... Burial Slippers and Hose I- .mbalmingBody(with.................._._...._......_...__.F7uidj ._._._._..... gashing and Dressing 'having . • . Peeping Body on Ice . • ....... --- Disinfecting Rooms -._.._ Use of Catafalque and Drapery - Folding Cbairs Candelabrum • • • . I Candles . . . . . -- - Gloves . . . . . . . . _... ...... Crape . _____. -- Number of Carriages ._.... ©$................... _.......... -. Hearse . __.__......__...__. Wagon Deliveries.----........-.. Death Notices in ..... ............... Nmspapers (Names of NewaDapen 1 Flowers Outlay for Lot • • • • • ' - Opening Grave -- Lining Grave Shipping Charges, prepaid — -- IRemoval Cbarges • Cremation Charges . Total Footing of Bill . • • • ' By Amount Paid in Advance k I Balance t. Entered into Ledger, page......_..._........... or .......... i Compiled by F J. FEINEArAN, SL Louis, No`, to Mho Yc:,r 1900. _...-__...__... ............... -- comMlou 6y F ✓. pE1NEMAN, SL .......... outs, Ma, to the year 1900•