Stewart, Genevive S This 11 Stab"to be kept by person issuing Permit.
BURIAL PERMIT.
1. Name of Deceased. AMAhtm . .
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2. Place of Burial. -4A1lk!1,,...�-- -�:.<!.
S. Date and Place of Death,-
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4. Cause of Death. ta
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6. Certified by...:f.,. 'Z,....( .
................................................. H. D.
6. Undertaker..