Norton, Helen J This"Stub"to be kept by person issuing Permit, y
BURIAL PERMIT.
1. Name of Deceased.
2 Place o f Burial.... .
8 Date and Place of Death...
i� ...
4. Cause of Death...
......... ...... ......... ................. ....... .....
S. Certified by. ... .:
8. lTradertaker., .... '.. . ....... ... ..d?: D: