Durfee, Ralph Permit for Burial, Entombment or Removal.
Issued to Ralph E. Durfee _ No
z Countyof Rutland
STATE OF VERMONT.
ci
z Fair Haven
p Town or City of
Z Date of Death February 8th, ^19'7
F Full Name Fang Kantrowitz Kaplan Age 43 8 28
3 • H . YEA', MO,IM DAYS
r Place of Death Fair Haven, Vermont
< a Disease causing death Influenza Eshaustion _
a F Medical attendant. _Drp,George D. Parkhurst -__
3 . Proposed date of burial, entombment or removal _February. 9th. 19157
u a Proposed place of burial, entombment or removal_._Town of Queensbury, New Yorki
z z y What cemetery or tomb West Glens Falls Jewish
0° Manner of burial, entombment or removal Removal and intenhent
0E
o
u.
Undertaker_ _ Ralph E. Durfee
m
a Address Fair Haven, Vermont. _
a
C A Certificate of death (or removal or transit permit) having been feted in my office in accordance with
V law, I hereby authorize the_Aemoval and. Buriot body of said deceased person as stated above.
a (RW4[, ENTOMBMENT OR R[xOve[) 7
441-2.41 as
Town cia Clerk.
Date_ February 9th, _rg 7.
This Permit, if properly made and signed, is authority for the burial or entombment in any cemetery or tomb in this Slate.
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at c E y ruby (rrrttfg. That I did, on the 7 day of 19a
,300� deliver the body described.in this permit to
F 26: Seaton or Keeper of _ emet r
8 Y 8 f Signed
a « C4 0 1 (Mott Mk hart)
Ent Pia ri Ent _ _ -
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aI C'a 3 Werrbg (Certifg. That I did, on the ___ ___—____ day of
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o u g 18ttta what disposition was load*of tho body.)
g l E.¢ the body described in this permit.
103° Signed_. _ _.
rx1 I '. mue. __ _ (Snton.or Kospr.)