Bidwell, Fannie This"Stub"to be kept by person issuing Permit.
BURIAL PERMIT.
1. Name of Deeeased..7a .'W's.....
� ... ................ ge,.. 6.
Place of.Burial.. . . r .
S. Date and Place of Death.--. «
...................
I. Cause of Death.........
..... ...............................
6. Certified by.rN
.. Gc.,� ..�.. ►
.X. D.
6. Undertaker. i ..u�.a
f