Harris, Robert NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
or 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.5601_ . . Registered No..194....,__..
Marren Town Glens Falls N. Y. 34 Rid
County - ._.............. _... "illage._._._._...._....._....... ....._._......_._,......._..:...._......_._._._....._....._._ge..._$t. t'
or City I If car. MVO stint address)
Robert Harris
Nameof deceased..._.__.....___.__._._._._._......__._._.._.___..._............._....._._..._......._..._-.__._._........_......._........_._.._..._._._........__....__.
Si
Sex Color„Color__._ t.Sr divorced (writ widowed,
word word) single....._._._.-._.....Date of Dcath.._.,Iu1y
Aee....14._......_._....Years__ __2 Mnnnce 25 n.,.._, Mi ninon tan, t .. •re