Norton, Curtis This id 8tll "+o be kept by person issuing Permit
BURIAL P'ERMC,IT.
,7. .Name of Deceased.... ..........!' "#- ...
...........Aye, ...... a
2. Place of Burial. x./'a.... ... .. .. ............
S. Date and Place of Death... . ....... .. :':. ,. .,t��
4. Cause o Death i F-7
.
. Certified by......,.....
... .. ...til: D.
6. Undertaker.. ....................... ...