Downing, Emma rorm V . 01. 6-10-3,-)0,000 (17-1423)
NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
gilir"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 .6QJ. Registered No. 244,
Town
County Warr en Village Glens Zalla Haapital
or City (If city, give street address)
Name of deceased Mrs. Emma Downing
Single, married, widowed,
Sex em a 1 e Color Whi teor divorced (write the word) WidOWASi Date of Death July 2.4.., 19 aL
Age 62 Years 6 Months 1 Days Birthplace...ilad.aan 21,, Y.
Cause of Death Chmmic Nephritis
Certificate was signed by
George L. k/asQy M.D.
Address Hudson Falls N.Y.
Place of Burial (or Removal)..T o wn or 41AgQ11.$.b1,117.y.4..c.i'DaLtiity of ..S.tate of Hew
(If body is to be temporarily held, fill in space later)
Cemetery Pine View Cemetery Date-of Burial July 27
(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 Joseph F, Regan Glens Falls., N.. L.
(Name) (Addresi)
the Undertaker to hold tempora i
er the body.
(Undertaker or person having charge of corkse) move, or oth ose of [state how])
Dated July 27, 19 3b (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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