McGregor, Augus NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
or This Permit can be signed only by the Local Registrar (Deputy or Subregistrar) of the Primary Registration District (Town.
Village, or Gty) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
DisL No..0 7)- Registered No_. _._ ....._..
County._.IC..I__.......... ._. _ �Vill•
lage_./Jr rerle 27 ,�.
�jy very— (Is city. give street address) o
Name of deceased ___ . _. _...._.—._.__ !"r._. ..._._.__. ... . _
• Si e. married, widowed,
Seep°__color.. _. ____ ivoreed (write the word). £.14&.. .. Date of Bath.. 6,—__19..432
Age—. ._._Year' ... ..yet.Q.._....\hmths_._... O )ays � � r �B�irthplac .. _.
Cause of lleath.. !r/,�- _...._._...L! !w ! .._._. ...._.. _ _
Certificate was signed by.
wA/c'e .JL3.._...._....... TAD
Address. ....__.__........._....._�
' Place of }It ' .. (or Renx)val) _ _.._. .....__._. ...__.._..... _ _.__..__..._._.___�__..._..._._......
(If body is t peran eld.6ll ,n sp later .. ..
TTrr��
Cemetery_...et4.:Gr...C.,.S,.0 '_..__.._ .._ .._.__. . . Date of Burial__. .. ......_...r_., ..p __.__193„)
(It body is to be temporarily held. 611 in space later) l
The Certificate of Death containing the above tated particulars, having; been presented to me, after careful examina-
t:911, 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 sts f EY GRANT...A._._P._E....R....M....I_.T
. ... — .. .240te ..._>et___.
J_ Ohms) (Address)
.O the._ _. !t.. _C-.L: to boll t,_., o aril an ' . . .... ._ ..__...... .._. ._..--...._ _the body.
( Err or per.on hsym qe of c Iloterr.�mare. r m i dupo,e of (cute howl)
Da!ed_.. w.._..f. [� 19... (Sigrt.l; ...._...�_'...'_.t' l�,r �._._—.._ •
Loral Regina
This Permit is sufficient for the Removal (and Interment or Cremation) of y to any part of the State (subject to local cemetery
or other reguiations), unless removal is by common carrier, in which case a Transit Permit IVS No. 62) is required.
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