RECORD OF FUNERAL
~~~~~~~~~~

No. 22
Date:  
Name of Deceased: Tom Peet
Charge to: Falls Co., & W. J. Finks
Order Given by: W. E. Hunnicutt
How Secured:
Date of Funeral: Feby 7, 1912
Place of Death: Country Finks Farm
Funeral Services at:
Time of Funeral Service:
Clergyman:
Certifying Physician:   
His Residence:
Number of Burial Certificate:
Cause of Death:  
Date of Death:
Occupation of the Deceased:
Single or Married:
Religion:
Aged:  
Body to be shipped to:
Size and Style of Casket or Coffin:
Manufactured by:
Metallic Lining:
Outside Box:
Number of Handles:
Interment at:
Lot or Grave No.
Section No.
1.
2.
3.
4.
5.
6.
Designate all Graves in Lot with Numbers (1,2,3,4,etc),and mark space for this Funeral with a cross (+).  Designate place for Monument with a small square.  Use space to the right of Diagram for namesof those buried in Lot.
Price of Casket or Coffin: $6.00
Price of Metallic Lining:
Price of Outside Box: $6.00
Price of Grave Vault:
Price of Burial Robe: $3.50
Price of Burial Slippers and Hose:
Engraving Plate:
Embalming Body:
Washing and Dressing:
Shaving:
Keeping Body on Ice:
Disinfecting Rooms:
Use of Catafalque and Drapery:
Use of Folding Chairs:
Use of Candelabrum:
Candles:
Gloves:
Crape:
Number of Carriages:
Carriages:
Hearse:  
Wagon Deliveries:
Death Notices in Newspapers:
Name of Newspapers:
Flowers:
Outlay for Lot:
Opening Grave:
Lining Grave:
Shipping Charges, prepaid:
Removal Charges:
Cremation Charges:


Total Footing of Bill: $15.50
By Amount Paid in Advance:
Balance:
Entered into Ledger, page     or below:

To Funeral Charges Total:
Falls Co.      $6.00
W. J. Finks  $6.00
 
By Cash: Feby 17, 1912   Falls Co.                               $6.00
                March 1, 1912   By Cash W. J. Finks           $9.50


Transcribed by: Lena Stone Criswell & Kay Cunningham
Note: I added the year to all except for the date at top. kc