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Page: of 255
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Date of . Cash . Number of F gwedlcaadteAMvenedned cnvedsds
a: Charges . Book,. Paymetits caeatriishiesk: ‘ DATS,
Payment Page . Number of fun: year.... Tree
SS Ls
Date of Death, ia
A Lipt. 15 is ed Casket, Pia
SLO Case,
ie Name of Husband, af Handles es Case,
‘Name Plate for Case,
noes See id oN awrncad hyn —_
Handles for Cae,
Name Plate for Case,
(M» ak. a Li wn . Rove Ne,
\ 49 ves, as ‘ . Crape for Bell,
; 1. \50 E \ wise Oke! Dita, G pairs Gloves for
s wd \ Certitea oy YG. L ary mm De Laying out, Shaving,
i \ coat tat ft Use and Cartage __Dos, Chairs,
“g ad gave x, wed ve \ _» om ne Services,
4p hes aia o' \ FS Mates
ik Y Father's Birthplace
g, a¢ : er ar
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other's Jame,
3 \ Lp part igs ° :
vost JA\oe
_____Cemete!
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ee Cate ~ a seat diane — . — sage ” P nevecstacnl bea ces’ ave,
oy ni juni lor curren! Peeve rseeseret ayme' Fes ber yea
— ate of Death, :
ia canes Oe G Name Plate, 21S\ 00. \Orr. \a¢. 160) 00 . Ock 21500. : ee
Name,
* su eo
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Chew des ert aly ove sete . Coffin,
Name of Husband,
an tea Chiat
Name Plate for Case,
Handles for Case, : i \
Plate for Case,
Age,
Crane for Rell \ SS yeas 76 Months, fl Days. , Crape for Bell,
Pras of Death, +
2. 00 Seliiery; Mei ant Pari Pairs Gloves for
Publishing Notices, Singers, Publishing Noti
_Certified by 4. iW o/e Septet In = Laying out, Shaving, _
\ .
\
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Asada CLR . Embalmi :
Place of Doh,
\ Mira . 4 ra be Use and Soran Dos. Chairs
\ PW os . Cemetery Charges,
; Place of Birth,
f Father" Name,
{ \ Father’s Birthplace, an FZ ' :
“ : : Lye trab Neti
i \ Mother's Maiden Name,
i; He Bea 3 e\ 2 Mother's Birypplace,
ae Cire Soret dined ikea ie
i yes Pe . ae fects, i . ¢ “a = ri Wises ef ‘7
fae Foo: oo} Or“ 1902 ae be er haie ae