Van Dusen Stevens, Catherine In €..L
This"Stub"to be kept by person issufng Permit.
BURIAL PERMIT.
Name of Deceased "�:.
. Place of Burial... ....
S. Hate and Place of Death.... .ti,to.��
/�. Cause of Death..Oam+ .� "�Wc4.��c......
S. Certified by:-.. ...
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B. tTncZertaker........... ......#-... :.... .'.....