Mc Neil, Etta (2) NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
glir 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. 5 601 Registered No 21
County
Warren Town 32 Harrison Ave Glens Falls N.
\��illagc x Falls ,
N.':.
City (If city, give street address) •
Name of deceased Etta McNeil
SiFemal whiteor
, married, widowed, Siri l eJan. 14 1938
Sex o]or or divorced (write the word) � Date of Death )
Age 72 Years 5 Months3 Days Birthplace north Ar rle� N. Y.
Cause of Death 7 oei~rditis chronic-3 yrs .—cardiac dropsy resulting-3 mos .
Certificate was signed byDr.. a.. A......Hor..t.on M.D
AddresQ Cr.l.e.I:ll$....F.,.,11.0.4 N. Y.
Place of Burial (or Removal)L171..11. O. Que ensb.ary.s....H. Y..
(If body is to be temporarily held, fill in space later)
Cemetery......_...i.n.e V.i.e. Cemetery Vault Date of Burial Jan. 1.7.., 19..t...8..
(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 CU\i I'LETE, 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
Harold Cf Stafford Glens Falls, N. Y, .
(Name) (Address)
the Unde•;^•t.•i.;L'•r to hold tempo" .ce in v.a, It the body.
(Undertaker or person having charge of corpse) ( remove, ther se dispose of Estate how))
Dated Jan. 17, 19... i. (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.
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