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Ide, Charlotte I I 0 Form VS.81. NEW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT tor This Permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Prun&y 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.. 3 93 •_ ___ Town Dist. Nc5641. County...Warren Village..Glans..Falls... or City (If city,give street address) Name of deceased Miss Charlotte A. Ide Single, married, widowed, SexilBRalColor... ittftor divorced (write the word) Simg,Q Date of Death.sTaY 7 19..rN Age 94 Years 3 Months .. Q Days Birth lace...$AX.'.4:44.gA... 9.e.e m..La. lC Cause of Death BrQ.x1S 3.4.P i .A4lRII,ii 3,.410.Y.$.r.Frac. l0ft .iP-9 m9o, Ar rorX04c er9pi,a —Certificate was-signed-by _ -.l r...Rra r...3....I , hstitt - - M.D. Address Glans...F.alls,...N..... Place of Burial (or Removal) To.wii..Qf...QQe.QXIsb .r....N.....Y • (If body Is to be Aemporarilyileld,fill In space later) Cemetery '2. View Cellletery Date of Burial July 101 19 39 (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 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 S..t....T.a...P©t.t+.e Mona..Egt11i6.a...,N• Is (Name) (Address) the QX�.% rtaker to hold tempora ' f �+'t.er / the body. (Undertaker or person having charge of corpse) , e t.,. dispose of[state how]) Dated Jl4x., Q.. 19.39.. (Sign. .. ... ... 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. of O m O p " O• Fr " C O •+• w �� s � R °' •"� r � »,8'$ ..,��.f,{nl. t" »,°'� R oB (o(ff� � day B "0 14 5 g y e to �•''o=n *v m AA 4 (,b W N �'1 ,�J Q. ^ f9 ^ [], A ^ G O fp f� t/1 f ' n 0,2 CM fir• X k%• ID 1 ." I:6 10•4'R "o•w o .0 7.55.0 UT' el g a°3.0 0°3• as w o 70 • ; l a. 2, d • •cnR N a s }q ^ O,l.^ m 5.g-0 ,•--4, rwV^ " n- Gpp oq K pap•" ..O V $.1 �2 1 v Q ^ iE'r r ^'dpa. :r . *d g "v Ef po4 r8 r o -v6' "C M O10q, =ga og o *Roa" ^ " .. 4-°��.�w �� �p1F • �,, � 0e A3° 1+ e , ° ^ v " t • Mtn " °q nit ^ .-0,1 " tartilt- o z "u o & 1-11r.--.4 ` a'�y � zw•� R' � �C a8 o MoaA F° 3x r.gC � � a.s � � �a°'Co 5'� •�row Er "s'� $ . 5g il Lis o p n WO 1 ^ A „ 0v001� ^ .i 80,70 i .,1O • rt p Aw . . w- - N , wB m f 60 " 0ce" , :; ..tr, 8-s ,i ^ g — E00'R .R"Mw.91G43 114 ^ NOW �►I ^ ^ off" �a ° .*... 0 0 ,. • „. P. ^ 0 ag 1' o •^+ �' g'^ ° w 21 05— cot, " Hoag w +-1 ›Zr" g„ 2 .ap�p i '2. ...a :o a) "n. w : " 'goa• .= " Rgo � ^ba-1-" xx 6'" > " "3 k : --- ',o. ;E:i �5. `Z g »A§L."" FEst 9j 014qtøiit!ti diIfl �• 1 w {p1,R 1 e "s1 •$' y 0ge.. � ' .p"�j�t �'f u•�i' .'tr,',=.•R,r� jpnfir' o ...� a�. O g " R �� agar„II g' . gg I w' o " R u ^ a uffi 'n � $o ^ ^c " �j ��+ �p° .O,e yii ^ _��ipo " .9.1 0. 0 01^%.o� ...zh-e, »g'g • o � �7 • is •o �+Crf i' n " �A "n? " ce :•" ^ ,�y fye ste croi � w a�• <f OO. A,^y ,,��2.� G r] �i • • " C 2 r 3w.• gIcro iv4as ^ .. " G ay ^ R § 1O paF "1•• . 'r.. Mr' i C7ryy0 y i fE �r�i M W C R-N' " O ^ a jam*m Gr.. .' I o e s: ,^y m a R , a " M w^ s ^�'" " iPLrfl Ire.o�, 4 -. Pl . �.000^QQQ " a0 0 . ° .g. 0-e4wR@:tq. "" ,*tpr$. Wis til : 5. •° IçUEu : 1 04(015o•`r"_ .51 nww.egraeii E. ° Ib . �9 _-•0 ».� rill, m> • 3w0 rLiIILI N ttitllii a. ^ 5.c. •C. • i9..S . ti .Aa• " O .. CAps•A -94-r ° $.n1 , p9-2.Ros.n —i gE nir1