Burdick, Aldon A This Stub to be kept by perwn iauing Permit.
BURIAL PERMIT.
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1. Name of.Deceased.. .V'rU.. :,,..,. .
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o.,Burial.eo,lv ,trw.O
Place, .�
8. .Date and.Place of DeatTa..t t f.If
4. Cause of Death.
4,
............I...............................
... .. ° ,
G« Certified by. . .
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6. Undertaker.. �n ��