Taft, Abagalde This i°Stub"to be kept by person;issuing Permit.
BURIAL PERMIT.
7. Name of Deceased. - ' � �?.`..... !?
-f" ..............4rge, ,fire'.
2. Place'of
S. Date and Place of Death... .�.
4. Cause of DeatTa.9 .aC_.., ,.
6. Certified hy...
.. .,f -�.........4..
......................................................�M.A
6. Undertaker. .". .