Patton, Charles ORIGINAL
r-
OFFICIAL FORM OF TRANSIT PERMIT
.� ISSUED BY TEXAS STATE r' l ARD OF BALMING
- —.- — - -- — — ----—— RAILROAD
PHYSI AN'S OR CORONER'S CERTIFICATE
.........................W.8.QQ,.. Mc Le — TEXAS
CITY COUNTY
(Ifin a
Charles Bullard Patton hospit deccurred l or th o institution,
2 PULL NAME_
Hqsnital Stree,i —Ward —— --of street and number Land
13 miles north of Waco or, Dallas rii-way. all out Nos.17a and 17b.)
PERSONAL AND STATISTICAL PARTICULARS MEDICAL CERTIFICATE OF DEATH
3 SEX 4 COLOR or RACE 5 Single, Married, Widowed or 15 DATE OP DEATH
' I Divorced. (Write the word) Dec• 29 ' 1939
2 Male White Single - (Month) (Day) 19(Year)
5a If married, widowed, or divorced 16 I HEREBY CERTIFY, That I attended deceased from
HUSBAND of
p (or) WIPE of -- ---.......____ 19.._—, to-----.—•-----------_�19------
6 DATE OP BIRTH that I last saw h alive on.-_-__—__—____--.—___--.-19_—_...
E June 25, 1917 19 a;
(Day)
4)
(Month) (Day) (Year) ILD
and that death occurred on the date sited above a M
W 7 AGE The CAUSE OF DEATH• was as follows•
a 22 6 mo 4 Fractured Skull
years.._ months._------------------days
•4 8 OCCUPATION
(a) Trade,.profession, or Student kilot U.S. "- -
iparticular kind of work ,„ (Duration)______.____._ _._____._...(b) General nature of industrrrmy Air Corps• years months days
F
i business, or establishment in Contributory_____—
which employed (or employer) Deo-._._-1_939 (Duration) years months days
1 9 BIRTHPLACE
)-( (State or county, CAUSES, state (1) Means of Injury;and (2) whether (probably)
city or town) Glenn Fal lS, 1,• Y. 17b Where was the disease contracted
10 NAME OP if not at place of death?—_.-_-______--____________.__—....._-_-__ _—_
PATHER D• J• Patton
Did an operation precede death?
date of
'4 p 11 BIRTHPLACE OP PApTHER Was there an autopsy?
W (State or County�b any, N• Y• What test confir diagnosis?......__--__ -__ ___ ____ —_-_. -
MAIDEN
R pi 12 OF MOTHER Ala d o 1 ene Bullard � - 1 (Aaar �—� s---
a 13 BIRTHPLACE OP MOTHER 'State the disease causing death, or in deaths from violent
causes, state (1) Means and nature of injury, and (2) whether
es (State of Coariyenn Fa -is, N. Y. accidental, suicidal, or homicidal.
Q+ 17a LENGTH OP RESIDENCE 18 Place of Burial or Removal Date of Shipment
s How long in U. S., if of foreign birth?.-_-years... months... days Glenn *Falls, ,4 F. • Jan• 1, 1940
a 14 The Above Is True to the Bert of My Xnowledge
19 Undertaker Address
(Informa4ep tC_ar ds --_o Kell Field
Address
San Anton -:— ••
Texas � — Wilk irson 8c Hat ch Waco, Texas
—_..------- -- ----•-•--•-•------------
TRANSPORTATION PERMIT
This Permit must be properly signed, and with Physician's Certificate presented to the Railroad or Express Agent before a body can
be shipped.
Permission is hereby granted Wilk irs On di Hat Ch under Embalmer's License No 1943
to remove for burial the body of the above described person from. +bra C O, T exa s Texas,
to
Glenn Falls , N. Y. (City) (County)
(City) , (County) (State)
and___Ge_Slet,ls___ ,t___ak likild_R_J a. .__.is hereby granted authority to accompany said body.
Signed___ __< ` Health Officer
Address Waco , Texas
ltu:e 70. No body of any person dead of Asiatic cholera, bubonic plague, smallpox, shall be transported, except in a hearse or under-
taker.'s wagon. unless said body shall have been cremated. n� 0/
n r an ',InchThn .,nn half of Chic chant ',Inch hn A .n ntnhnel of ne,-+hat, f.,..,t;nr• .,.,A h.,nAfr. n n na-nr1 f +ha 0CGOn illn aro, hn of the, n
Laws Governing the Preparation for Transportation of Dead Human Bodies
Rule 77. Bodies Dead of Pestilential Diseases. No body body, and see that all necessary precautions have been taken
of any person dead of Asiatic cholera, bubonic plague, typhus to prevent the spread of disease. The transit permit in such
fever or smallpox shall be transported except in a hearse or cases shall specifically state who is authorized by the health
undertaker's wagon unless said body shall have been ere- authorities to accompany the remains. In all cases where
mated. bodies are forwarded under Rule 78, notice must be sent by
telegraph to health officer at distination, advising the date
Rule 78. Bodies Dead of Contagions Diseases. The bodies and train on which the body may be expected. This notice
of those who have died of diphtheria (membranous croup). must be sent by or in the name of the health officer of the
scarlet fever (scarlatine, scarlet rash), glanders, anthrax or initial point, and is to enable the health officer at destination
leprosy, shall not be accepted for transportation unless pre- to take all necessary precautions at that point.
pared for shipment by being thoroughly disinfected by (a)
arterial and cavity injection with an approved disinfectant Rule 84. Bodies Not Shipped by Express. Every dead
fluid, (b) disinfecting and stopping all orifices with absorbent body not shipped by express must be accompanied by a per-
cotton, and (c) washing the body with the disinfectant, all of son in charge, who must be provided with a passage ticket
which must be done by a licensed embalmer, holding a certifi- and also present a full first-class ticket marked "corpse," for
cate as such. After being disinfected as above, such body the transportation of the body, and a transit permit, showing
shall be encased in an airtight zinc, tin, copper or lead-lined physician's or coroner's certificate, name of deceased, date
coffin, or iron casket, all joints and seams hermetically sol- and hour of death, age, place of death, cause of death, and if
dered, and all enclosed in a strong, tight wooden box. Or, the not a contagious or infectious disease, the point to which the
body being prepared for shipment by disinfecting as above, body is to be shipped, and when death is caused by any of
may be placed in a strong coffin or casket and said coffin or the diseases specified in Rule 78, the names of those author-
casket enclosed in an air-tight copper or tin case, all joints ized by the health authorities to accompany the body. The
and seams hermetically soldered and all enclosed in a strong transit permit must be made in duplicate, and the signatures
outside wooden box. of the physician or coroner, health officer and undertaker
must be on both the original and duplicate copies. The under-
mine 73. Bodles Dead. of Non-Quarantinable -Oontagions taker's certificate and paster of the original shall be detached
Disease. The bodies of those dead of typhoid fever, puerperal from the transit permit and pasted on the end of the coffin
fever, erysipelas, tuberculosis and measles, or other danger- box. The physician's certificate and transit permit shall be
ous communicable disease, other than those specified in Rules handed to the passenger in charge of the corpse. The whole
77 and 78, may be received for transportation when prepared duplicate copy shall be sent to the official in charge of the
for shipment by filling cavities with an approved disinfectant, baggage department of the initial lines and by him to the
washing the exterior of the body with the same, and stopping Secretary of the State Board of Health at Austin.
all orifices with absorbent cotton and encased in an air-tight
coffin or casket; provided, that this shall apply only to bodies Rule 83.__.Bodies Shipped by Express. When dead bodies
which can reach their destination within forty-eight hours are shipped by express, the whole original transit permit shall
from time of death. In all other cases such bodies shall be be pasted upon the outside box, and the duplicate forwarded
prepared for transportation in conformity with Rule 78. But by the express agent to the Secretary of the State Board of
when the body has been prepared for shipment, by being Health at Austin.
thoroughly disinfected by an embalmer holding a certificate,
as in Rule 78, the air-tight sealing may be dispensed with. Rule 84. Disinterred Bodies Treated as Contagious. Every
disinterred body, dead from any disease or cause, shall be
Rule 80. Bodies Dead of Other Diseases. The bodies of treated as contagious or dangerous to the public health and
those dead of diseases that are not contagious, infectious or shall not be accepted for transportation unless removal has
communicable may be received for transportation when en- been approved by the State or local health authorities having
cased in a sound coffin or casket and enclosed in a strong jurisdiction where such body is disinterred, and the consent of
outside box; provided, they reach their destination within the health authorities of the locality to which the corpse is
thirty hours from time of death. If the body cannot reach consigned has first been obtained; and all such disinterred re-
its destination within thirty hours from time of death, it mains shall be enclosed in a hermitically sealed (soldered)
must be prepared for shipment by filling cavities with an ap- zinc, tin or copper-lined coffin or box. Bodies deposited in
proved disinfectant, washing the exterior of the body with receiving vaults shall be treated and considered the same as
the same, and stopping all orifices with absorbent cotton, and buried bodies.
encased in an airtight coffin or casket. But when the body
has been prepared for shipment by being thoroughly disin- Rule 85. Transfer of Bodies in Transit. When necessary
fected by a licensed embalmer as in Rule 78, the air-tight to transfer dead bodies in transit from one railroad train to
sealing may be dispensed with. another, or from one station to another, or from a station to
a ferry, the affidavit of the undertaker and permit of the local
Rule 81. Persons Accompanying Bodies Dead of Contagi- health officer accompanying the remains shall be in all cases
one Diseases. In cases of contagious or infectious diseases, sufficient authority for such transfer.
the body must not be accompanied by persons or. articles
which have been exposed to the infection of the disease, un- Rule 86. Certificate of Undertaker. No common carrier
less certified by the health officer as having been properly shall accept for transportation any body unless a certificate
disinfected; and before selling passage tickets agents shall is furnished by the undertaker preparing such body for ship-
carefully examine the transit permit and note the name of the ment to the effect that the foregoing rules have been com-
passenger in charge or any other proposing to accompany the--- plied with in the preparation for transportation of said body.
,.ad., ( 5G6
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