Hopkins, Laura Howe This"Stub,,to be kept bg person issuing Per—
it—BURIAL PERMIT.
1. Name of Deceased.. �` .
Plata of Burial. .
S. gate and.Place of Death., �c .• ,��j...
. Cause of Deat7a. -*<.....
6. C'erti led by.......... ........
..... .. ..4f.D.
6. `Undertaker.4e�--