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Gleason, Willilam 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 WRI 1"1 EN IN DURABLE BLACK INK. Dist. No. 5 601 Registered No Town County "' . . Village - r•arr.en C.©.a�ldge.... va...G •ergs Palle, 14.i . or City (If city, give street address) Name of deceased Wi ill am j-1,, Clea, ,e,n ,:a 1 e Mt t e Single, married, widowed, Sex Color or divorced (write the word) 111aX'X'.ie.d Date of Death... 3 3.7 51 11 � z� May 19.... . Age Years Months "'6 Days Birthplace... i�. .sXly..} IL. `C... Cause of Death Coronary ThrQ.mb.Q.at.e-10 days.: per••• •an .i•c,n4Ar4er4o-sore *•ae•i• )}-•a- Yrs Certificate was signed by N• R. Fr a S.j.er M.D. Address G1.a] ..... a.11s., N.. Y... Place of Burial (or Removal)..........0x. .4.X1 '.al.l.i., N. Y. (If body is to be temporarily held, fill in space later) Cemetery Ping Vi.W,1 C..ene.t.£R.ry Date of Burial Ic y a, 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 Berry W. Woodward Warrensbur , , _`_.. (Name) (Address) the Undertaker to hold tempora • u.eir` the body. (Urtrata ker fir;ersgndt}' g charge of corpse) emove, ise:::::r0f [state howl)Dated l (Signed).. 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