Dickinson, Sarah rurm VO. ua. O-au-JJ-JU,u UU \a/•a TCD)
NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
mEr 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, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Dist. No. Registered No.
Iik
County `Marren 1Tllege 193 South Street ,Glens Falls
9P`City (If city, give street address)
Name of deceased Sarah E. B. Dickinson
Single, married, widowed,
SexPe.m,1..e..Color.w.i.j..e or divorced (write the word).........Vf(.i.d.QV!1. .Gi Date of Death May 29th 1937
Age 7...0 Years 4 Months a Days Birthplace Qlif ton Park,S a tug
a,.kgo.
7re_ Cause of Death acute....my.ae.ax.dit.i.s — 2 da.. c.ar..c.im.Qma p.0 .: .Q.m to h - 6 mos. Y'c
Certificate was signed by W.S. . .Q.W.en M.D.
Address glens Falls N.Y.
Place of Burial (or Removal) Pitle Vi.e.zx Ce.Z AQ.t.G :y
(If body is to be temporarily held till in space later)
Cemetery Pine , iew Cemetery Date of Burial May 31st, 19 37
(If body is to be temporarily held, fill in space later)
The Certificate of Death containing the above stated particulars, having been presented to me, after careful examina-
tion, the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED 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 thereof I HEREBY GRANT A PERMIT
to JQ.aQ.p F. Regan Glens Falls,N.Y.
h .*
(Name) (Address)
the UtzOQrtaker to hold temporaril d... 1.BteX the body.
(Undertaker or person having charge of corpse) emove, or otherw' e dispose of [state how])
Dated .Allay 2.9.th 19.3.7... (Signed),.. ..
Local Registrar
This Permit is 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.
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