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Johnson, Andrew (Original) TRANSIT PERMIT NO. Railroad. - TRANSPORTATION OF - CORPSE. NEW HAMPSHIRE STATE BOARD OF HEALTH. PHYSICIAN'S CERTIFICATE. Name of Deceased C ;�. --I"— r" Date of Deatli F , 1,7 7 - (If a minor,gi bents'name also.) Hour of Death M. ge. / Years Months / Days Place of Death / Cause I .44.. .. '•P ''-Y1-�r� is this a communicable Disease �i I hereby certify that the above is true to the best of my knowlle d belief. •,,/C ..-;_!41/ t ' ._,Je..,4_,......,e,c ,,,,,. 4,. ..e. , Residence J '-�-44-r Q County of ., - '-' . State of -'`4II PERMIT OF I1OCAI; BOARD OF HEALTH. This permit-must be properly signed, and with Physician's Certificate presented to the Railroad or Express Agent before a body ,� can be shi ed. In the `/ r ' of —� '``- 2 .. County of (City or 10 .) State of i-.` - on the s ., day of -tr.-4- 4- 19....( Permission is hereby given ti" v% ‘ `e Q�--( r'' hold re' of Emb mer's License No./I-f to remove for burial at �-''" ...,4-- ' in the county of * State of fr- r .e j, the body of 4/, .<', u "- who died at - - County of - `--C--,r` '-- 'V State of ` , ,j'`-— �,on the day of 1 / Aged ,A - Years Months Days 9- is hereby authorized to accompany said remains. Signed Health Officer or Sec'y Board of Health. RULE I. Tne transportation of bodies dead of small-pox,Asiatic cholera,yellow fever,typhus fever,or Bubonic plague is absolutely forbidden. This Permit and preceding Certificate must be detached and delivered to the Person in charge of the Corpse. Rules of the.New Hampshire State Board of Health, for the Transportation of the Dead. t" RULE I. The transportation of bodies dead of smallpox or bubonic plague is absolutely prohibited. RULE 2. The transportation of bodies dead of Asiatic cholera,yellow fever,typhus fever,diphtheria(membranous croup),scarlet fever(scarlatina, scarlet rash),erysipelas,glanders,anthrax or leprosy,shall not be accepted for transportation unless prepared for shipment by being thoroughly disin- fected by(a)arterial and cavity injection with an approved disinfecting fluid;(b)disinfection and stopping of all orifices with absorbent cotton,and 'i (c)washing the body with the disinfectant,all of which must be done by an embalmer holding a certificate as such,issued by the state board of em- balming examiners. After being disinfected as above,such body shall be enveloped in a layer of dry cotton,not less than one inch thick,completely wrapped in a sheet securely fastened,and incased in an air-tight zinc,tin,copper,or lead lined coffin or iron casket,all joints and seams hermetically sealed, and all en- closed in a strong,tight wooden box. Or the body being prepared for shipment by disinfecting and wrappings as above, may be placed in a strong coffin or casket,and said coffin or casket encased in an air-tight zinc,copper,or tin-lined box,all joints and seams hermetically soldered. _, For interstate transportation under this rule only embalmers holding a license issued or approved by the state board of embalming examiners,, after examination,shall be recognized as competent to prepare such bodies for shipment. RULE 3. The bodies of those dead of typhoid fever,puerperal fever,tuberculosis,or measles,may be received for transportation when prepared for shipment by arterial and cavity injection with an approved disinfecting fluid,washing the exterior of the body with the same,and enveloping the entire . body with a layer of cotton not less than one inch thick,and all wrapped iu a sheet securely fastened, and encased in an air-tight metallic coffin or casket,or air-tight metal-lined box,provided that this shall apply only to bodies which can reach their destination within thirty hours from the k -time of death. In all other cases,such bodies shall be prepared by a licensed embalmer holding a certificate asprovided for in Rule 2. When prepared by a licensed embalmer as defined and directed in Rule 2,the air-tight sealing and bandaging with cotton may be dispensed with. \� RULE 4. The bodies of those dead from any cause not stated in Rules 2 and 3 maybe received for transportation when encased in a sound coffin or casket and enclosed in a strong outside wooden box,provided they can reach their destination within thirty hours from the time of death. If the body cannot reach its destination within thirty hours from the time of death,it must be prepared for shipment by arterial and cavity injection with an approved disinfecting fluid,washing the exterior of the body with the same,and enveloping the entire body with a layer of dry cotton not less than one inch,- thick,and all wrapped in a sheet securely fastened,and encased in an air-tight metallic coffin or casket or an air-tight metal-lined box. But when the. body has been prepared for shipment by being thoroughly disinfected by a licensed embalmer,as defined and directed in Rule 2,the air-tight sealin' and bandaging with cotton may be dispensed with. RULE 5. In the shipment of bodies dead from any disease named in Rule 2,such body must not be accompanied by persons or articles which have been exposed to the infection of the disease,unless certified by the health officer as having been properly disinfected. Before selling tickets,agents should carefully examine the transit permit and note the name of the passenger in charge,and of any others propos- S ing to accompany the body,and see that all necessary precautions have been taken to prevent the spread of the disease The transit permit in such cases shall specifically state who is authorized by the health authorities to accompany the remains. In all cases where bodies are forwarded under Rule 2,notice must be sent by telegraph by the shipping embalmer,to the health officer,or,where there is no health officer,to other competent authority Y . n \'''....4p.' at destination,advising the date and train on which the body may be expected. RULE 6. Every dead body must be accompanied by a person in charge,who must be provided with a passage ticket and also present a full first-, class ticket marked"Corpse"for the transportation of the body,and a transit permit showing physician's or coroner's certificate, name of decease l`:I r date and hour of death,age,place of death,cause of death,and all other items of the standard certificate of death recommended by the America Public Health Association and adopted by the United States Census Bureau,as far as obtainable, including Ihealth officer's or Registrar's permit foe,' ' removal,whether a communicable or non-communicable disease,the point to which the body is to be shipped,and,when death is caused by any of the t diseases specified in Rule 2,the names of those authorized by the health authorities to accompany the body. Also;the undertaker's certificate as to, A, how the body has been prepared for shipment. The transit permit must be made in duplicate, and the signature of physician or coroner, health officer,and undertaker,must be on both the original and duplicate copies. The undertaker's or registrar's certificate and,pester of the original shall be detached from the transit permit and securely fastened on the end of the coffin box. All coffin boxes must be provided with at least four handles. _ k. The physician's certificate and transit permit shall be handed to the passenger in charge of the corpse. The whole duplicate copy shall be sent to the official in charge of the baggage department of the initial line,and by him to the secretary of the state or provincial board of health of the state or „4_ province from which said shipment wasimade. •/ RULE 7. When bodies are shipped by express,a transit permit,as described in Rule 6,must be made out in duplicate. The undertaker's certificate 1 J and paster of the original shall be detached from the transit permit and securely fastened on the coffin box. The physician's certificate and transit ^y permit shall be attached to and accompany the express way-bill covering the remains,and be delivered with the body at the point of destination to the" el I' -\ person to whom it is consigned. The whole duplicate copy shall be sent by the forwarding express agent to the Secretary of the State or Provincial �\"' Board of Health of the State or Province from which said shipment is made. i RULE 8. Every disinterred body,dead from any disease or cause,shall be treated as infectious or dangerous to the public health,and shall not be accepted for transportation unless said removal has been approved by the state or provincial health authorities having jurisdiction where such body, NI is disinterred,and the consent of the health authorities of the locality to which the corpse is consigned has first been obtained:and all such disinterred re- mains,or the coffin or casket containing the same,must be wrapped in a woolen blanket thoroughly saturated with a i-i000solution of corrosive sublimate and enclosed in a hermetically soldered zinc,tin,or copper-lined box. But bodies deposited in receiving vaults shall not be treated and considered the �N" same as buried bodies,when originally prepared by a licensed embalmer as defined in Rule 2,and as directed in Rule 2 or 3(according to the nature of �"g �1 the disease causing death),provided shipment takes place within thirty days from the time of death. The shipment of bodies prepared in the manner above directed by licensed embalmers from receiving vaults may be made within thirty days from the time of death without having to obtain permis- sion from the health authorities of the locality to which the body is consigned. After thirty days the casket or coffin box containing said body must be enclosed in a hermetically soldered box. RULE 9. The bodies of all persons who die in New Hampshire that are to be shipped by public conveyance,even though the initial point of such shipment be a railway station outside the state,must be prepared and forwarded in accordance with the regulations in force in the state of New Hampshire. RULE ro. All rules and parts of rules conflicting with these rules are hereby repealed.