Parker, Ester This a0 Stub"to be kept by person issuing Permit.
BURIAL PERMIT.
1. .Name of Deceased.... ..........
.....................
2. Place of
S. Bate and Place of Death..
............... .. . ......?. ...r..�' `f
1. `Cause of Death.. a.t.. ..........
.......1/7 f A ..................................
Ci. Certified by....Lefr; /..f .........
............... ........................ 2 A
6. Undertaker...... .. .........x.......Gt.