Bennett, Warren Leo This"Stub''to be kept by person issuing Permit.
BURIAL PERMIT.
1. Name of...1pOA.14_1-,Yv V't"ZV
..........
Abe,..
2. Place of Burial. ...
S. Date and Place of Death..�.. + ..
. . .. . .. ...................
4 4. Cause of Death.�
.i .,c. ... ............. . �'.,?., . ........
5. Certified by. � ......
..........................k...........................
6. Undertaker. .