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Blondin, Rosina NEW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT 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 Oi DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Dist. No..5.6201, Registered No. 309 Town County warren Village 1. .0 S.ou,th $t,.,Glens Falls, N, Y. or City (If city, give street address) Name of deceased Rosina 3londin Single, married, widowed, Sex.r..e.tA.c'.,.i.e.Color...Vlthi_t.Q...or divorced (write the word) married.d Date of Death NOV, 13, 19 37 Age 49 Years 4 Months 14 Days Birthplace Win lover, O tar.],.,, Canada Cause of Death Cerebral hemorrha ;, ,,Art.e.r.eo 3ole.ros.i.s-6 Iz1.o.s...hyp.e.r...t.ensi.o.n-6 Has. Certificate was signed by Dr... Harry De.pan M.D Address Glens Falls,_ Nt Y. - - Place of Burial (or Removal)leSt, Cr],ens ,Falls., N.. Y... (If body is to be temporarily held, fill in space later) $..: ... Alp onauS E.e.. met erj Date of Burial Nov. 1 Cemetery .6,1 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 Lionel J.. .o.iu.i.n Glens Falls, N. Y. (Name) ..� (Address) the Undertaker k. ..r to hold tempor, ' nt e r the body. (Undertaker or.person having charge of corpse) t , remove erwise dispose of [state how]) Da ed Nov. 5, 19 3�7 (Signed) .. 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