RECORD OF FUNERAL
~~~~~~~~~~
No. 42
Date: March 7, 1912
Name of Deceased: Jake Gauff
Charge to: Pilgrams by B. J. Mathis Masons by Henry Buckner
Order Given by:
How Secured:
Date of Funeral: March 3, 1912
Place of Death: Falls Co.
Funeral Services at: Mount Rose
Time of Funeral Service: 2:30
Clergyman:
Certifying Physician: Davidson
His Residence: Reagan
Number of Burial Certificate:
Cause of Death:
Date of Death: March 2, 1912 11:50 am
Occupation of the Deceased:
Single or Married:
Religion:
Aged: 53 Years
Body to be shipped to:
Size and Style of Casket or Coffin: 5/9 1400
Manufactured by:
Metallic Lining:
Outside Box:
Number of Handles:
Interment at:
Lot or Grave No.
Section No. 211110
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: $57.50
Price of Metallic Lining:
Price of Outside Box:
Price of Grave Vault:
Price of Burial Robe: $12.00
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: & hose: $.50
Crape:
Number of Carriages:
Carriages:
Hearse: $15.00
Wagon Deliveries:
Death Notices in Newspapers:
Name of Newspapers:
Flowers:
Outlay for Lot:
Opening Grave: Flowers $5.00
Lining Grave:
Shipping Charges, prepaid:
Removal Charges:
Cremation Charges:
Pilgrams by B. J. Mathis 65.00
Masons by Henry Buckner 25.00
Total Footing of Bill: $85.00
By Amount Paid in Advance:
Balance:
Entered into Ledger, page or below:
To Funeral Charges Total: $90.00
By Cash: Pilgrams March 11, 1912 $65.00
F??yman May 3, 1912 $10.00
B. J. Mathis for Masons January 7, 1912 $10.00
B. J. Mathis for Masons October 7, 1914 $ 5.00
$90.00
Transcribed by: Lena Stone Criswell & Kay Cunningham
Note: I added the year to all except for the date at top. kc
