Taylor, Ella NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
plir 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 I I hN IN DURABLE BLACK INK.
Dist. No...5..60.1. Registered No.....1 2,,
Town
County Warren Village Olens Falls Hospital
or City (If city, give street address)
Name of deceased Ella Jones Taylor
` Ingle, married, widowed,
Sexf entale Colorcolorer divorced (write the word)divorced Date of Death April 17, 1937
Age 51 Years 9 Months 2Q Days Birthplace Ga,nsevoort, N. . .
Cause of Death......ti7.Q.neral Al t,eri.o—sclOrQS1S— t;j.X'.dIy.pQI'kQX1s rS?XI,-fit y..r..e..;:JrQrlla-3d.�jT t...
Certificate was signed by Dr .......IrVi.X)C....R R. Juster M.D.
Address 7.1.ins Fa . :. .., I:, '..,
Place of Burial (or Removal) Town of Queensbury., 7rren Co . ,.N.Y.
(If body is to be temporarily held, fill in space later)
Cemetery ..1.1.n.o 7.1..Q;:r QQ4IQte1',y Date of Burial ,Ap.. .l.....204 19 7
(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 t3arold C . Stafford lens Falls, ". Y.
(Name) (Address)
the.......... .11d. .r./. . e r to hold temporar'� i --cam�e r the body.
(Undertaker or erson having charge of cor se) !!. e, or of 'e tspose of [state howl)
Dated .April 2Q.,. 19 37 (Signed)_.
Lo_al 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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