Baldwin, Linda Form VS 61. 6-8-34-50,000 (17-7901)
NEW FORK STATE DEPARTMENT OF HEALTH
OFFICIAL, BURIAL, (OR REMOVAL) PERMIT
''This Permit can be signed only by the Local Registrar (Deputy or Subregistrar) of the Primary Registration District (Town,
Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE OF
DEATH, LEG Fr IN DURABLE BLACK INK.
Dist. No..... Registered No.
WTown
County $
i or ei _ (If city,give street addr
Name of deceased -� /� '' C 'pp c-ef""",
Single,married,widowed, . // �J ) ( ,
Sex. for .. or divorced (write word)....l /.1(....... ext> Date of De h .. . . 1 ..
Age �_�^ Years 7 onths D ys Birthplace
Cause of Death ,_. .:'- � elt. �h
Certificate was signed byrt�RZ a,...�7 s M.D.
Address j —'t','�'Ci1- ice`...... -2--
Place of Burial r Removal) `7 �/
(If body is to be tern ra ly held,fill in c later)' `�
Cemetery Zr2.LL ..G Date of Burial „n J 19. _
(If body is to be temporarily held,fill in space later)
The Certificate of Death containing the above stated rticulars, having been pres 'ted to m , after careful examina-
tion, the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REOUIRED BY LAW,
I have accepted the same for registration, have recorded it in my Local Record with the above stated Registered Number,
and on the basis tWeo��RE�"� T A PERMIT ,�� c, �jl
to -� . - ., f -c.�_ — /2_
—t( .70-67,-e-,..„
) (-tkt�dress)
the °'...Lif..-.�- -( .4 .. / temporarily ,.c� body.
..: ........ .. to hold tem oraril ar --'`� the bad .
(Underta or pers ha,�ing charge of rp ) / : (Inter,remove,or otherwise dispose of[state how]).
Dated . 19 3 (Signed) ,:f It `-
Local Registrar
This Permit sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local cemetery
or other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
i
E"'Z° 0cd '~~ NQ,Qvo4° cd• 0cS0cd02--•O =.y)..N1ro �Ho O.�•^ " N0 2.ffiLNU Gto.:by 4Wt
in W� bao 0.do1. cf.2 :c:w:N s � a4qa .y : cyQ�b..yoao.'p. aEUvJ7a,a °.. rod.Cer.,o^ao ,.-0•.ap a..=.so Ua aa�"•o ,..m vz oNoa, 3 ~ �.mw.}, cdNcd '>+-0 ,° o 1. _ .. � a, 0 3 �0vv,
kr °, , . cc > bo c, a . E - 0 p'-E1' Eu3.� -,.143Z
ut -v5b: a ., a>A °waco . - a) ,p +' � p.a yW [14 cd 0-,- cya, u, - , .. � a, a)' c., ° .�C'
: o °u ,� ,
.0 „ I. as ,y•' � O N O t `'' Q
o . " du °. 1U,�. o •� , O O Qs3 .� 0•oNw° t° °". pdcU O'.-.- a� Zp
3 E 0.• 0 NGO*+ a- o
, t, s, Q 0.) .-..0 a o da> a.•CG-. U •C -o0. i1...
-
...0
b
�
a �/. + o >;U b bA• y O O •a.�.0 cd a, o ,~ a C y y O O U O.� d d ta,,.., «CA•.,)'
w
u O' a+'y bwa, n .. cd•ic „ m > by t. tdp, Nv� Gb a 'A w om O.c . t. A}' U„wa.b t, U 00 O
NU'r Cm -' ta a 4 W' � - t. o > ' ' -. aU o it ° 4 y. y � t. -0... 0 oS ° tia �" o aQ3E' yoo > a, q .mt aa•''��A ril �, P 'p is+ �^7 Tp U - " C � 1. >N04.) • w0N c, ° °E.c•L.° * , O , O w. 4,a yiU 7' •� �y>ir.S.. co aV A Zd.' t, o ., cd.4 v'o cd.rIO
Z F aa � t, a "0�dyE - ° ^ a ab a
7 V .d-o o U.n,° Oww0 ,, aO N,N ta, V °•.p • N ° N 8 NO ' QQa -.b n ..t a
, try H a, ..0 0O •a d a, U U � U ay t."-, p0.) .O• A-e d m Z. 0 .ai w , A" W a U O �•~ C� OU� � ° '" '� v � O � � ma� roW� 0
ZW • airoa' ° v „ ' w ° c' a . -[ d • N ,� , 1 � A > b , 75Aan O Uaid a 'L..G , s. U O r, . ' •4
O , wWF w � N,c,dN U a . a t • . ..,. d p > CA d d0 . ° t au y V cc, ab9yt W O
utr0Oa EI� 0U.� >>d.N. bNZ'O N� UN ° a % kpC u + >> (S-S aUda,_ �.. y, Q ..,C�w "co' .dWC/N N�.[� o> ° w• 1U a,�'CI 'o 0 >,0 co Ts' Z .�l•
., b�A dx Q °w.y"G NN t.'O v.. cdNd rdcd V 8 �a 3 , b wa+
aW •'q".quFF.1z , O 'm.4: a•U o � ~� C a N•N r C�U r .CY _.d v.....,- q y.. E•d Q.. w ° �w° ,,o Ny.c > N byZW la F yu . VIO,, � ° 5w dO- •5za Y w•4Y ° a, -" t...5,. A<up
,WyyW •o:"a a dZ O aD1-,y^ >xG > � voa o a, cd . t. w C t. cdw A A .., o-o a, N E >'a .W at
d-- d s. i N„., c. 1~4' t. i• ......o y Oa, p3 ~ d o. ..- oao O 0, N U b Q�Oa.
a.
Cil
U"ri
a►� 'E ° 4 Q-o bv-o NoyUU > avdO >, Uw•, N U+ a t- p0 . ,.. — 0• > O . . O1d .emuy ••0 .. m}' .= ... c •� Uwd wo ° > �nOZ , •UmM Fs O N _ ba7.� '[y . 0 § ,..,.. aAp'".•3U dvCN^ ew n A_. ffN ., c.d_ a) ymZ .V z i o O.5 r.+...,s a ,,, .radN «_ 0... ° d... y na , , ,.. � �4. 'u_ rp � :, 44Rl> ..u, � � 1. . „ U.'C.4t d .2-0 3� ad % U ." vm °, ow ~ Ua 0 ,4,.•' Cat.... 4
i. vs> o d a, UF3t U 4GtUo;w >•t °,Nm•o �3'�mw .. �' •~'0 a,,, d $ u6wO �' �'b•° oc', . E pp O'0Z0 a ia a
p�►+ ,, E a 0 r-y a a,U04y 'b ,to ' •o0y .84. m4..-400p aN .Mo cd .174= -()0~.. A a, c,�.. s. 0 � EX r [-I « ° • O .. d. Z y s~ .y r, � ... 0 bA., d ,Li; 0 > O, a�, C _i > _,° ha -. Hz0wZQv o.. q "0. m i, U° oNO6.�d:0 °> atiz•01., > vs4o a, ,0ELa � C'Su00U d Q.>.. " .) G UOwO " a , C' '' -4U U;G '., p1) � y„ 0 ,fl
O2 N0M .WoFO t •o °o0z U `;:'4 oFg O U N 4y' 1 o dU �' UbAky , av y. N ai:5 N0., O Y g
w B E_, m W 1:3O ••s O Es),-d.bq..'cd! OL._ gM Vicyd1.� N vaOa Oa ° v^ AO
• : A. N.� . o °. cdaows ZEZZWO. N -' ° °`"'-ci a•ow8 " 5 wx O1a 'tlU1.� aya >,a ° dO U.N Oacd-o— "' COUlWU Wka H +' 8
1 ° Ea, aO * oZ 'th d
"0 y ? omt"• QNU' 0 ~ AU' aU � a:.... O cv, d Lm
, wvaov '0 a a., y ty,Se aO � Ou O, `* U y ° o > yO ,, c•i= C coF Y•.1 W Nn,a ; , o V O .. p. p . 2, cd ,,,,,a'a' bp, 3w ,.,,� U .maa Ucd N.. aiv 'o..N. 0 N 'byZ2 00g w. G bo> .ti 0Oa .- N ° OU y yw..o a y a dO.-•.- 5a , ga aS.., y a t.w
a) bvd , . °.-. ca,-. 5.-• . E, 1.~ w0Q .�'" UpbOa, � °.aOWW wN >. Ua frs 0 d > a � s..N �. ,c4 . ..., N. , ,00N� a� � Oi:: >' = d. ~ a•.. Grt. d ° pA toOoatG f a, d "0-aa~, N rot. a) f ~ > O .~• OZ . o
w a O• ,,., U ,,,���QaU U'n c O . t. .. CI. .E wMO ° Cl) ybOX a, a,a Q •)'t I: ca 2-6 o bq .> ; N Fl
°141
Il
• •u O . yc yu . cd .. a0,) sUdI-. N ,Y. AOa,.-. . a Q a, w.. . O e t.L. u . 0 0 .SaN UCI) Uo O O w ) . �b .. a � , x � ° dd k'E+.>„0 A yay0'`' N U tom�•4 -U. 0aG.0 •.1 .1a,+--0I-. d 4. 7bUN0b> O*' 0.). . sG"0t.. WLO i1n 01:0 u•^? d a, va0 y..p.+ O p, y ° U. ..q pw .CwUO ° O.-. >,^1O •1•O ' ° Uva - C ° yoL 'cd•O... 6, Z nw p,0 U 0 U Q, .. O • .G,C Oa > •n':. N,- .-. A O i. -0 N .0 Q O Oy t w..,A O>i : u 1\ a, ON it. 0- O .0.` cal-0 wUC OiO a ,0 N ° 2. . M ,a d ,L',° N bq•' ' wZ w d o d,.e.- 1. M. •O0E te >•_ o . = CN Ov, 0 . y , .... --d = v N a,,, O � , L. CYO cd A4.ca ' > a .'" NC. 0, U q .. iawW da'8 ^ ZA am N tt. E O aO gci 0 1~ . cN ids 'II'bD°y O A a.p1 t. t.° y .- T 61' v . El N N co i[ G, O a�u- • Na Ua C 1b • � d °d 0. Ttr O U OO a • N ay a, 0 a t
n.
-~" ' ''' -.�..• 3vt. U..•y .0 b0 p' ,t, ,bq a, U �•.>. a, r+ql As t-1 arwA VI ,- .. ao s~.+ ti~ ol& d' U•0t,x U O �` , O U.a.. U q �, , a, 00 t- 0 a, t. O 'Uc, s- a•. y ao wmo >w3 0 13 a., a N a s c3.., a a.. (WTI... o 0 u t o 0 cd.4 0 t.xc #d t. 0,0 b0. Cu
a