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Page: of 307
ILE
Number of Funeral
Number for the Current Your Leb
Be careful to enter name of deceased and number of page
in index for future reference.
Items of Bill, (cross out printed items not furnished.)
Name of Dec’d “OL tye CS
Late Residence (vu Gidetleeee
Door Crape
Draperies. Candelabra and Candles.
Age QZ me monthe a days. Washing & Laying out Remains, Shaving
Cause of Death Cltitten fe Preservation of Remains
Certifying Physician Oy, 40,40, Yack No._-Casket. -_. Trimming. Fy >
Date of Death patch 2 y ri tar “cei ZA. oe ~ Z=
Date of Burial z Au = No G 7 oe hn ne 4 fn
Funeral at House-or EE Ghaget. No.....-Plate engraved
Plage eu 2 : Cemetery. . . Outside Box, (Pine, Chestnut, Oak, Cedar)
ee LEI. Yi elaeL-. Section No PI't’ H'dl’s Corners on Box.
Delivering to Cemetery
Location of Grave [a5~ No Robe
Pr aogute Ids'ohe with : Wi ouble Cress " Prs. Gloves Linen Scarfs. J. 5 O
Show position of monument by &. Use of..... Doz. Chairs
tt Flowers
Inscription Hearse ¢ 7 LEA <z
wh Plate. Z Carriages to ord Ly 2 a. —
feet L h to Heel
Measurement ength to Hee
be SLAG G. of gr Lise Ma
Ld 2
Width at Shoulder
Bill Rendered to
When Rendered
MEMORANDUM.
Advertising
Cemetery charges
Transportation Expenses, &c
Attendance & Assistants
Amount of Bill 4422
Amount Brought Forward
LLY /\ 3B
Amount Carried Forward ULLL5 Jd
PAYMENTS.
ITEMS OF EXPENSE.
Ay Va BT RA ee aed thee ‘
% >