Kaplan, Fanny Permit for Burial, Entombment or Removal.
Issued to Ralph E. Durfee No..
Y
z County of Rutland _STATE OF VERMONT.
V
z Fair Raven
O Town or City of.__
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6 Date of Death_ February 8th, 1917
F Full Name Fanny Kantrowitz Kaplan Age 43 8 28
3 , YamsMOMTM. Dan
Q Place of Death Fair Haven, Vermont -_
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aDisease causing death Influenza Eshaustion
a'r Medical attendant _Dr. .GeorEe D. Parkhurst
34 Proposed date of burial, entombment or removal redruary "8th, __19157
6 a Proposed place of burial, entombment or removal___Town of Queensbury. New York
z West Glens Falls Jewish
z w What cemetery or tomb— ----
ct :oC5 Manner of burial, entombment or removal — Removal and interllient
aF
Undertaker Ralph E. Durfee
C
aAddress Fair Haven, Vermont.
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a A Certificate of death (or removal or transit permit) having been filed in my office in accordance with
law, I hereby authorize the_Eemoval _and_Eltr_iYike body of said deceased person as stated above.
C.7 Ieu.ul. EMTOM.M[MT OR RIMOVAII
Town osl Clerk.
Date February 9th, - _ 1947.
Thu Permit, if properly made and signed, is authority for the burial or entombment in any cemetery or tomb in this State.
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Ipst e 3 *ray (Certify.. That I did, on the day of 19
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T."t deliver the body described in this permit to.
2.0 v Sexton or Keeper of. _ _— ----Cemetery fo
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3. Signed
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3 3 eredg (Certify. That I did, on the --__ _ day of
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' p�+ • c e (Stab what dLDwlwn was made of oho hod,.)
oiv .g the body described in this permit.
.g I Z d3_BB Signed_ - — — --
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