Chandler, Percy F This'A Stub"to leA
pt by ersou 1--i-I Permit:
BURIAL PERMIT.
1. .N�amo of Deceased. ...•......
. ... .. ... .......Age,.+ ,.
. Plaeo of Burial.., .'.......... .;.
S. .Uate and Place of Deat7a.1. •. �..
4. Cause of.Death. �
6. Certified
.............. ... .............H. D.
6. Undertaker...............................................