Rowe, James rurau•o rra. .a•<r»vu,uou la -�av�) ,
NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tor 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 4:25 Registered No. 19 _el,
Town,
County 3ar..ato.ga.. Village 3 9ttl,.y larv..ill ei .,t Y.
or City (If city, give street address)
Name of deceased James B. Rowe
M. W Single,married,widowed, ;fir r i ed December 13 37
Sex Color or divorced (write the word).._._ Date of Death f9
Age 36 Years 8 Months 14 Days Birthplace '..Pr..t....E.d.k9.i :..d
Cause of Death Coronary Occlus ion — Health Officer case.
Certificate was signed by E• J e Call lah an .• M. D.
Scliiylerville, N . Y.
Address
Place of Burial (or Removal) Glens Falls , N . Y.
(If body is to he temporarily held, fill ins ace later)
Cemetery I'i .a.....V.. . .w Date of Burial Dece mbe r 162 19 37
(If body is to be temporarily held, till 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 0 . W. Closson Schuy1ervi11e , N . Y.
(Name) (Address)
the Lln.de.rt .k.er to hold temporarily an Inter the body.
(L lertaker r ,erson In v' g charge 4,§orpse) remove, rr otherwise • sta how)).
Dated eeemb�r iv, 19 1 • (Signed) Y�
.< _ Local Registrar
This Permit is sufficient for the Removal (and Interment or Crematio f a body to an rt of the State (subject to local cemetery
or other regulations), unless removal is by common carrier, in which case a ransit Permit (VS o. 62) is required.
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