Wood, Elizabeth E This"Stub"to be kept by person issuing Permit.
BURIAL. PEPMIT.
1. .Name of Deceased. .. ,
............................. .........Age,..14.
2. Place of Burial... .
8. Date and Place of Dealh..LIA.
Ouse of Death....
.......... ........... ..............
S. Certified by.. .............
......................................................
f 1},
6. Undertaker..