RECORD OF FUNERAL
~~~~~~~~~~
No. 23
Date: Feby 8, 1912
Name of Deceased: Jack Snead
Charge to: Dr. J. C. S?????
Order Given by: Jack Ward Rosebud
How Secured:
Date of Funeral: Feby 9, 1912
Place of Death: California
Funeral Services at:
Time of Funeral Service:
Clergyman: Bergis
Certifying Physician:
His Residence:
Number of Burial Certificate:
Cause of Death:
Date of Death:
Occupation of the Deceased:
Single or Married:
Religion:
Aged: 9 Months
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. 142425
Section No. 14630
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:
Price of Metallic Lining:
Price of Outside Box:
Price of Grave Vault:
Price of Burial Robe:
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: 3
Carriages: $12.00 each
Hearse: $10.00
Wagon Deliveries:$2???
Death Notices in Newspapers: $2.25 Paid 3/5
Name of Newspapers:
Flowers: $6.75
Outlay for Lot:
Opening Grave:
Lining Grave:
Shipping Charges, prepaid:
Removal Charges:
Cremation Charges:
Total Footing of Bill: $12??
By Amount Paid in Advance:
Balance:
Entered into Ledger, page or below:
To Funeral Charges Total: $39.00
By Cash:
By Check: Feby 9, 1912 $39.00
Transcribed by:
Lena Stone Criswell & Kay Cunningham
Note: I added the year to all except for the date at top. kc
