Brunett, Peter This"Stub"to be kept by person issuing Permit.
BURIAL PERMIT.
1. Name of Deceased.. rrl. ..... �, "
..............................................Age,., ,
�. .Place of Burial... ..k4"AA
S. Date and Place of Death.. ......... . .' � ,..
. Cause of Death..V ............
5, Certified by,..Qr..
.................. ...................................aid: D.
6. Undertaker.,:... .............. . +,,,,