Fleming, Alice Mary -�--� t
This"Stub"to be kept by person issuing Permit.
BURIAL PERMIT.
J. Name of Deceased—a ,,;jt4..,..
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.................Age,. .,�}+W
°L. Place of Burial... � �.�r....
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8 Date{and Place of Ueath........)1.OIJ...14—wi
4. CaUse of Beath, °:V193- -Wjo ....
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J. Certified
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6. Undertaker.............................................