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Duell, Alphonsus
This"Stub"to be kept by person issuing Permit. BURIAL PERMIT. 1. .Name of Deceased.... ........ .......... ....... ..Afe,. 2. Ptac9 of Burial ...P..... ...... ....... .....,..... S. .Date and Place of Death... .. �-- ......... ........ ...r.v....... 4, Cause of.Death.. ..... & Certified by.... .. ........,. ................... ......................................................d .A 6. lUndertaker... . . ... ..... .........