RECORD OF FUNERAL
~~~~~~~~~~
No. 1
Date: January 19, 1912
Name of Deceased: Miss Fannie McCann
Charge to: Dr. W. H. Allen
Order Given by: Dr. Allen
How Secured:
Date of Funeral: January 20,1912
Place of Death: Marlin
Funeral Services at:
Time of Funeral Service:
Clergyman: Bergin
Certifying Physician: Dr. Allen
His Residence:
Number of Burial Certificate:
Cause of Death: Organic Heart Disease
Date of Death: January 19,1912
Occupation of the Deceased:
Single or Married: Single
Religion:
Aged: 62 years 7 months 25days
Body to be shipped to:
Size and Style of Casket orCoffin: # 1400
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 names of 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:
Price of Burial Slippers andHose:
Engraving Plate:
Embalming Body:
Washing and Dressing:
Shaving:
Keeping Body on Ice:
Disinfecting Rooms:
Use of Catafalque andDrapery:
Use of Folding Chairs:
Use of Candelabrum:
Candles:
Gloves:
Crape:
Number of Carriages:
Carriages:
Hearse: $10.00
Wagon Deliveries:
Death Notices in Newspapers:
Name of Newspapers:
Flowers:
Outlay for Lot:
Opening Grave: $5.00
Lining Grave: $1.50
Shipping Charges, prepaid:
Removal Charges:
Cremation Charges:
Total Footing of Bill: $69.00
By Amount Paid in Advance:
Balance:
Entered into Ledger, page or below:
To Funeral Charges Total $74.00
By Cash: January 24,1912 $20.00
February 3, 1912 $5.00 paid Johnson
February 3, 1912 $54.00
Transcribed by: Lena Stone Criswell & Kay Cunningham
Note: I added the year to all except for the date at top. kc
