Cronklite, Sarah This"Stub" to be kept by person issuing Permit.
BURIAL PERMIT
1. Name of Deceased- -_
- -- — ---- --- -------- -- —
Sex - -----------------
- � 4
. Place of Burial -`_ _ _
8. Dale and Place of Death:.--_ 4....z.------_--
— - x= ---------
4. Cause of Death...
5.. Certified by- :•-;•-•-
--------k-----------------M. D.
6. Undertaker ----------------•---
Sold by C. E. HOUGHTALING,Law Blank Publisber,Albany, N. Y.