Parker, Sidney W This"Stab"to be kept by person issuing Permit.
BURIAL, PERMIT,
1. Name of eceased.. &.-44v�
• .
. ..................
2 Place of Burial... ..
. . .. .................
8. Date and Place of Death. ,...& ..
.IL.I•, .... • .......................
1. Cause of Death.. .. .......... .. .
P
5. Certified y.
.................... ., . ........,. �
6. Undertaker..