Bayle, George Form V S.61. 10-21-37-25,000(17-3459)
NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tar 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 CERTIMATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Registered No. ``
5601 Marren Town 27p Glen GI
Dist. No County Village s s @l ,' .. ' 1.x,s.,...I�t....Y.«..
or City (If city,give street address)
Name of deceased George F. Bay13
Single, married, widowed,
Sex Male Color White or divorced (write the word)... cried. Date of Death. r.gh .1Q 1939..
Age Years 6 Months 12 Days Birthplace Bald )4t t s .W.$.gil?r , ?g:.SI ..Q9•
Cause of Death Cerebral thrombosis (6 ,year ) ,....Ar.y.erj,0...>ec1erQ.siis 4.7...3z.ears) N.. Y
Certificate was signed by J• Leonard Byrnes M.D.
Budson Falls N. Y _ _ __--
__ - - Address a.... r
_
Place of Burial (or Removal) Glens Falls s N. Y.
(If body is to tempo y held,fill in space later)
Cemetery t 'phonstts -Cemetery Date of Burial March 1.3s 19.',t9...
(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 ona e basisthereof I HEREBY GRANT A PERMIT Glensa
to.... wr Potter '...X .g.,..N A...i..
the Undertaker to Cold temporal' intereddress) the body.
(Ertigertaker or.pe son having charge of corpse) remo , sewi dispose of[state how])
Dated arc a ! 19.39 - ( fined).. .. ,.. . . .... .... . . ....
Local egistrar
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.
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