Tremblay, Daisy 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 Oi-
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Dist. No.5601 Registered No. 7
Town
County Warren Village Glens Falls Hospital
or City (If city. give street address)
Name of deceased Daisy M. Tremblay
sex Femalecolor white Single,divrcemarried,wrteith word) widoted llate of Death Jan, 4, 1938
Age 52 Years 11 Months 26 Days Birthplace johnsb)dr.g N Y,
Cause of Death L.Q.ia.ar FX e..uma.xl.i.a-3 days
Certificate was signed by D,r.. Harry I ap= M.D
Mdres' Glens Falls, N, Y,
Place of Burial (or Removal) West Glens_...Fal.e., N. I.
(If body is to be temporarily held. fill in space later)
Cemetery St. A1P.hQn$Us cem.et.e.ry Date of Burial Jan 7, 19 38
(If body is to he 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 SATISI ACT(.)RY 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
j basis
thereof pI nHEREBY GRANT A PERMIT (� p y� �+ �j T
fro Li.o_nel....J./l J.�.Qi.Y. .hA Glen F.al.1.s...,..L.Y.A..C..
(Name) (Address)
the TJn4.?rtakQ.X' to hold temporari' n .. to the body.
(Undertaker or person having charge of cor se) T .. .r e, or other ose of [state how])
Dated Jan,. 6, 193t (Signed ..
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.
JG = =C -t ^ S?' C -� O O 'G N b b 5'A .d b '�b ^.rb '4 O = .�.< O T... 0,O li3
T .... j-._ ti ^ .- - r�i fD •i r 7 -+ C'�'"'� S w _S P7, �i p W py t^' y 0 7 »_.7.C •� ._.:� �. ^ V 7 '0 V1 y0
: ra.� ?•ea �g.., ., � 1.�.,-.o .. � ^+ o -- - `; o = �, a~oo3RA� ', xv Ta A tri
�'
Z. . -, z'r --^J •i ^'y .y n C.0 A�� (' - _�"� ..GGC O n� IN ,- =.G.,. ..— w n 3.< „Ts O O A • w '7 >b ^ Q 0. O
_ _ y N _ Ra ya T
y� r - _ rxoA) - o00n o _ .zcoc `—• -• cS.•..V°„ - -wc. _ •w . z:G" EGv . !', , 0(A2
y R. m• _- -..-^ .nr D ... -. T�'T. .�'_
N .-. w - G- _ _ _ -_ - O V S -.Ol O R .'�• 0
VI
A = ~LI. __cij n H O G• H -wi A _n . -z dr' r - 7 = A ,z _ - _ n 5.,, n'< r 2 R xril S•.cn O7i [i7
4z. t.n ' c/� -•r' 3 .•-- 1 :: a=_ " c: _- - = - = - 5'o -� n v' G ►/ 7' `"j Boa "A
C^ _ .. •-•: C .. = 2. 'a 2 O - - -- - _` -, 7 < m O FFFjjj��� d_ pig O A Q. , 4 Z
.,• _ '1 "1 S r p .Z +. � .-. •w�T•o C: _ _ ,.w � _ � - "�•ri CJ QQ ▪ T� fl ,7 �.,j t
_ - w !: -'»N S-Q.M 5, -.,n Y A TO - n * C - - 1.• -t _ - - w.ti ^~. F..N..•w A A 0.3m 10 9
r S"" tetw ..z3woF• -=G• r- - ='O *;' _5, = _ _ _- a►"i At4rnn ,,r. o m 0
•
.f n .4- _ 7 C Y C y .^ y _.: - -- C.2, J. _ - = •C_ �..-' - O m'b�►rR 3 O
.T7= _ f ^ ` - _r_ _ `_f0 J C -n R - _ __C v n r"�r1}��� �77ll�,E T D �9 >Z 01
y,..m J - 1 :/. 0 r-R t. 't; .. .� 17 . Y R .,.�• !'J^ - J _ - -9 _ ", - A R N R fp (A 1'
•,/7 • r:� =�•W ....� N S 00 � (: S S _ �'•� N ^ _ ^" - ._-' _ -.. r 0 O •C /y Ly
f. - _C. n S�S: C - .'JS-�W' N _,^ ,.,/G^ -'l _ -• •C G ._ .F _- gin r - A co T�a. 5-0•G� ; X 74
rl C.' . s �, • °=� w ' " � ?r R 0 • _ `< ' c z -r ,3 ^ - ^ ,f9 ~� - _ IEifl
: y=„, y oM s - - • •6 <`< wp SCx O'�•3 tin _ - -' • -5'- o w O4 . C _ .i O - _fi " My`J `,
elE -• = _ _ = O 0.v o o _ _ I.▪ co - -, _ "J'- .'T n ` „.,c _ .i :n a h w10 A 0 r.r
_ _^..+.�'O ^O �• C' =^ �, A ?� n _ :� t�_ n C _ .y C C O C'� yp� S� G.a
n _ p�y
r` r� tayM• ON to r,^ (; � 0.-,, .. - �, nY. �,� = n •'� G `tC =.�..e ...Ge% `rb 2
C °: • ^ f9ti - ", ,,,n o2 w :� ^ c � oeoc _ • s: - _ _- Gw � ^ c, cVl d
' C"< - =eGo30 ' � �- ��vaR _ � e, , yw �� oc.Nac e�7� Nr On
ww -Ie o ^ , - n C - -fin • ^. p
C C T .y 3•S O O -•oOQ o w
p2..�o -= - w ..r�� o oco� o. �'F � nro � c = ' _. •+ -' mac o5' N "1
,.Zs - s. ^ 0 w c ° °T.:N'o. -•" - - - 3 0 o a;. R " _,• - o _ _ ^_ ,0,,•n n w.e TS.. t . X_t�j,� L)
tom ^ : r; 7c'D N .'O•O r• F•S- =� N 5 O=•^ - r - - .N. - =oi _ - t' G.
e .p aS=roy~•0+0rRsp »� T.� bn ~2 n �o ::wn c ^•al-' .,A,"wAm� o .n" n �� y0r$t �� [i?
1 � `.• c 3 < A7ro 3_o a J >•-, o -.=o Via.-1 5' = E. »,_.�'"o -M� <ti < „N R y Gr
meLo •.5 - too -'„ao >•aw .moo H � � o owno5o .wO �, Oru �o • N
,. 7N_ R R TN r.. re Tin n n N N •, O rn a Tre ..00 ...5-s R 2 R 2-.N T_ 0.,. 7 .� O y `