Duggan, John Form VS.6L NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
to 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. ._.___
5601 t�¢arren Town
Dist. No County Village 16 Mission St. ,, Glens Fa11s,N.Y
or City (If city,give street address)
Name of deceased John Joseph Duggan
Single, married, widowed,
Sex male Color white or divorced (write the word) single Date of Death Feb. 25, 19 39
Age ---- Years --`— Months } Days Birthplace Glens Palls, N. Y.
Cause of Death Birth Il-.jury(Cerebral)- .,,.,clay
Certificate was signed by Dr. Arthur A. Davis M.D
Address (Ilene... .':$ll.^�?a...N:...Y.
Place •f Burial (or Removal) At West Glens F0.11s, N, Yt
(If bodn is to be temporarily held,fill in space later)
Cemetery $ti.a...4a. b,011.61,1ii ..Cemetery Date of Burial Feb.e....4r5.a 19.39.
(It 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 OXvislaQ WWx...Q41 .: .s South Glens Falls , N, ys
Up.d�rtake
(Name) (Address)
the to hold tempora .1 Into the body.
(Undertaker or person having charge of corpse) ,re erwise dispose of(state howl)
Dated F61?, Pi`�a 199 (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 regu.. dons),unless removal is by common carrier,in which case a Transit Permit (VS No. 62) is required,
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