Baldwin, Almira E " This 14 Stub"to be kept by person issuing Permit.
BURIAL PERMIT,
�. Name of Deceased. . .
�. .......Age,..�.'�.
2. Place of 13uria1
S. Date and Place of Death.... �.
. Cause of Death........ ...... ...........
»�. ...............
S. Certified by...............................................
arl
6. Undertaker. . .
. :. . ...