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Jan 1st 2011!⃝Well, it's been made clear that the album is about the life and death of 'the patient,' a young man who dies of cancer.
I feel like the most obvious meaning of 'The End' is that is symbolizes his death specifically. It's the first song, as you all know, and it begins with the ticking a respirator, which means that he is still alive. But at the end and the transmission to the next song, we hear the beep of the machine signalizing his stopped heart and ultimately, his death. He is lying at his deathbed at the time of this song, and he realizes that his final moment has arrived. Hence the lyrics "Now come one come all to this tragic affair."
The lines "Wipe off that makeup - What's in is despair. So throw on that black dress - Mix in with the lot.." feels to me like it's too late for pretenses, it's over, now you got to face what you are and what you've been. It's the moment of truth. "Mix in with the lot" can be a way of saying that he will just be a part of the dead now, he'll be walking in the parade of the lost souls.
"Another contusion, my funeral jag. Here's my resignation, I'll serve it in drag. When I grow up I want to be nothing at all!" I interpret from this that he is leaving all the pretenses behind, that he's finally being whatever he wants to be without caring, as he might as well go in drag for all he cares. And maybe that no one on earth truly knew him.
I think there's underlying references to My Chemical Romance, and maybe even the fans, too, as mentioned before here. It's telling everyone as well as themselves to be who you are and live the most while you got the chance.
