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Steves, Baby girl Form VS.6L 10-21-37-25,000(17-3459) r71 0 /-er-i-abvt. /1A -ita- NEW YORK STATE DEPARTMENT Or HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT ta- 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 OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Registered No._..._................�.....• � Town _ Dist. No County ka... :/.z Village -or-City (If city,give st t address) Name of deceased t(.t.b.(i gin tic /Single, married, widowed, Sex...&na Color... i. or divorced (write the word) in„Ta n Date of Death _- 0 19 Age Years Months Days 3 ) 4 . Birthplace �i7r7 -dtY...at" 4 Cause of Death -,lX .....,..a€-- - - A Certificate was signed by V•A kY. A3d w er-li M.D. Address C7/.ern s i�c./(-s' a N:..Yc Place of Burial (or Removal) s,Tge.r..x,..t t at.i..l.t (If body is to be temporarily held,511 iq space later) Cemetery Q,a.e.4-t1. AP-si .......!...N:..y.. Date of Burial......f.'Ac : % 19. 7 (If body is to be temporarily held,fill in space liter) The Certificate of Death containing the above stated particulars, having been presented to me, after careful exami- nation, 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 on the basis thereof I HEREBY GRANT A PERMIT to A O.i.—era. VY• l / ..KIR ig g.ra (Name) (Address) the fn. k... [4... > to hold temporar' and /i it — the body. (Inter,remove,or herwise dispose of[state how]) �`.t Dated (Undertaker` or person having charge19 of corpse) (Signed). 7U .6 Local Registrar This Permit is sufficient for the Removal (and Interment or Cremation) of hod to any part of the State (subject to local cemetery or other regulations),unless removal i4 by common carrier,in which case a Transit Permit (VS No. 62) is required. t"PI 1 ! II gOpn .+,..•O .•..... "n '.n "'Co.ww0� a .wn r�Otinfo � `•'na.ro._, cw rap ..O•fD to cat C0� .•r n N 695 r s . 7. pa wA.0�'rona Pppi .4el, ..WnOo. for...- ; na0yown.0 .-, o .-' ma.fow , er 0 •p. 0 $. O 0 0 .�np En m =C ='Cnop� coy 'r= Co.p-= .ai.O+,,ia ntne-n0 `ttrgm 'rotp ,ya,.6- ` ;; 1ot n co 0 �+. '5, � 1+7 p;w �,;m °,`' ,.,,w �''co, • H i p n ne°;C a.. CO�:.• �•C m a.°,•< = < = fnn £� ,O,fi fe Fos, °' • jr°`.�..�i,)O v t ,k3 o� roa.° ° oaNmn .. 5 *8 ° � ;m �n cr� afa. .0. °c � Cv0 t6 (1 An .. § o n o 1• .;...fflNpofodwM ..ox p ='s n8 .. w " NO'A p ii ! P ° • nCCDforoan wf° 8n0wcp (p ro dQ5O. a.n OO .A COO ., fo a p a r.20 piog C •n ii a 0 MB,..•M, .pj. ,� OQ �, n - r, nr> g ono►,. C pNfo n . — nwoO �4 r,y o. . `. o, `g fD N a a,-,er o a.� .10 @, L'•..g f-o`C ..... 0•w K y Ct. o a C ' a b3 °, fD °-�. FCro " ::.aw 8 N0Leow .0nN0 ° ..-Cw N $, _ �� ? nW�y C p p' ` nrt7C N 0C pfo .. for -a ..° 5n ..i0 &I roO' ° GNQ' Fro. 0 • m{z� y �.' nO .± nro .. n O� On 0. JC"''Qp Aa. wnwgCo CS Ris .. 1•. to 0 .o .' n 5.8' 0 w K o E w 0;;�flo A 51. D a'`-'•PI.T. 1 "N i•'!'t R•p g � W Ps4W.'5.0.."n .. O .-.° g'g ..0'O frog .M'"�A --,Tr=- rt.n w} ,"3 a ,W nCr.G.g 0*.°q ar R'., n0 co� as .0rogarynn 8'gAnw0tr w o .+''= a' fDa�a ..� n4,�• 00 y rt. 1 °. C Pixy 219 0 n n d 0 i�ro ?-.� = -o k 4.o ° n • .0 o 0.0 a, ° o o m a'b a.:1"t° °e n 1 p o g • 0 ° a PC 1.5 a.Pi Ntl4O,A' n" glCD .°j8a.ni9 .. „'n2o..-..w .Oe .n098g'0^Aen�.*0aOalpb S g IV F.t4r7 K .n A 04 ' tIftIP t`q c' p Orjro n t' Epe. 00 r. 5,1:3 '. C. , 0g»K � . n• eno r*� ,foy o...e con O o'p rn n n n O a ��.ty Q 0 �, � "7� 8. ,=0. i, a.8gwp = • ..1.on 'Et of g'g ''' goo fig•;o ©n ,..,,,e orona.w80 p* p w >44 x5Nmn .'•D'O. 80 ..ag. 5nnt'Go5fo m2fo'n •, p�•5.p� cooPDa•a�g nfcoWt ira c0► „ ° PC ' Nx on' a 7..0K . a4 . �ro J~ c) aw'.- (Ts oaro ro ,f' a,~1 a ° p pal ►+iir►L�rl ftio 'tt n o p pp {x+n ° O n ...--p, n °�`�L�*08. a 4 r7� O �'�1p n pq .O a .O' M• t n fp N N N 'n ny ° a. one , n CD .t '.fe ..fro CD G 0+� �. A M r fo �.g 8 'IR NwA .A•tiPO rofDfo PD'g 0 g Cfo 8 fw, ° OP. P. .n`•' 0 � ' ... n n '0fo a. +'. n co a.�- a r.+ .... ji' y , N Yn°,yo '. •r, r., w" . °gy2 , n a-- n • - ° � 8-o'aq MroNa.a LA O � Cl1 Ct1Z O'Av0 � � fp Cr,'14 ro.--t 0n -1co 0 ..0oix .+r.non 00 °0 04• g Siy..^'e � ,.00a. pi ; • e• oq fP.w - 0 N 0 ...om a n x n ,8 k n C o Cs.2 ►3p.. '*�+ #, f .... C. c N,2o� 8o001, w ° 04--rA � afao ,,,° o M 5;" alloEl.-, 0cfao :�gn ��'8°�y ` ' .2. Z g6 ° 'ohm 0EL,.° "exny 0; liii jI �- •O an 0 .••.-`o° *0 2,.E.„40 o n °'y-0 a° Da =g,p.I • n. p0 , ai m, ro o" �,'a.w o „'d .... ..»,r. o A C.►,� ':n n fo , ° n ' gee o nyN 90 n •, o f°, u n ° � z'-'° NC fnp �`� ►. LTJ 03 o a� Co,Cfa atz .1n '640. 58 €0 <b :+ na .; w0n•no oro m �1 .,. yC i'6 g. o 20� .ey ,w, "n� CDCpQu' Si ON .... L1v"i pC 0ta .0.ro Nm 0-...C .°*U, a'[i7.2. ?:'g A R:I'8.w a'�7 M ;r.:N p 8'4 4e h ?'0,O 8.5•w 4 w G.°,n 8 P.fao ° v% :'1 5. Pri.