Brann, Elmer rorm VJ. 01. 8-100)-)o,VVV (1/-1't
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 OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Dist. No 5601 Registered No...1.14
Town
County Warren Village Glens Falls Hospital
or City (If city, give street address)
Name of deceased Elmer Harold Brann
male 4Vh1t@ Single, married, widowed, sin le April 37
Sex Color or divorced (write the word) Date of Deatht 19
Age S.I.I.LLL. 'eTli Months Days Birthplace al...ens Falls , II. Y.
Cause of Death A.s. hyxia Ne a na,t.Qr i um
Certificate was signed by Dr. H. A . Bartholomew M.D.
Address Glens Falls, N. Y.
Place of Burial (or Removal) T PW ri QS Q1t.e..Q.ns bur,4 -Arran r'.I✓.I C.Q...... N, X,
(If body is to be temporarily held, fill in space later)
Cemetery Pins Til..i.e.w C.e.l.e.t.er..y Date•of Burial April..... 1., 19..32..
(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 Harald C.. Stat .acd ..G.1.ens....F.al1 ss., U. L.
(Name) (Address)
the Und.e.r.t�ks•r to hold temporar'A a / i the body.
(Undertaker or person having charge of corpse) - , r,.•ve, or othe pose of [state howl)
Datpd....Ap.ni1 3., 193.7 (Signed i9� / i ' I`,
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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