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Pendell, Orville Form VS.61. NEW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT o' 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 Dist. Nod a/ County .Village City (If cv-give street address) Name of deceasedle way/ �r Single, married, widowed, vy�� 2 3 Sex- �'tt Color or divorced (write a word) "1 Date of ►,- 19. C Age G Years /0 Months. aer Birthplace . . . Cause of Eeath .l , .. . .. Certdcate—was signed by ,, Q'l--' Place of r urial or Remov %�J///�_' (If body is ,. be ` aril el space late6Lyr�'G� /� 7 a"" Cemetery CCC//��' C '" ! Date of Burial ,_ 19 44 (If body is to be temporarily held,till 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 :ccept-. •e same for registra ion, have recorded it in-my Local Record with th above stated Registered Nu• :,,,,OP •e f EREBY GRANT A PERMIT to... ` (Address), the•• �-.1. . to hold tern,.rari an the bod . (undertaker or person having charge of [state se) (Inter,rem r of howl) y Dated tL.JZ.,,3 19 "&. (Signed ,,,....�.: Local Registrar This Permit is sufficient for the Removal (and Interment or Crem on) o a b 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. Syro 'oom *JD •wEEne0 o �� P' oo1 ��o •, O-t7� w � � nv a »-. ©..,1 ,,� , r, SK ; ,, o°nA•A ; waNA c '' w ., ►-��� ''°°;: Ao °,� �o $,'° " 11 � Cl�1 • z.q A ,..A a-• 01 tl 'y O - w w pq.G., 5 ,. "eb 0 0.0'Q co3 W•t ( 1 z w' -a., a'O -I N Ct "9' ,"ty w.� ' g .. d".3 '.Y ° z Piixa w..0�" a0 .Oy rv ......W.... �.� A wNApe�Dwwe�Dww_. r:0a.»,5•ti a.AW tilt x p0 " 0 .,,.WV1wO' �'< a''DAO'trCH "� ODOro su aA.O•.,VA. w•e to=� C 'y OQn ��A "� ,wyO P, ay d..y�p p0.� • G 4."1:X g.od a.o -Ooaww°+ •.. w8AA: t°?N,� OwN"'N'(' oa °elt ;a = og00 vC�p .. 0 ► i.--i o.., A —051 enjAO ER *0.-- - w -.4.40 ..aNw © fl < ww '0,k W IN_ a' 5„ ww ,. A o .O... *. "oa°avA 'rs r. O .; amap°, O_. i4oir Ctl " a°p w A o. -� o D, " w 8ii! t '-' et • ,*i'p• z' o '+ wAa0+`�'+p C y,�'e hi•i Sig ell°11" 8.29.V40- dt p w A w 5•A , hw •e Rt "fir A+ y • ao mmo A er... P4.0 "eQ''A.m=C 5 w 5 8`.10 5''0' --.5'r--bIJ w +o �5 ep _ n• C G 05. „ �0 0 90'p M `' to p.• m..: .. `+'S:_ 0 CD 0 .h,ti M p•o A .:•* •f.D O0•,T' a.., A.--0 e' 'fD 0, fZ A;, o -m PI A mo n _.. i-" 0 as " E ti a 0, .,.ao , .... *" w w o- .'.." ---' r e Out Q o-nwo '+ o'Po5g.��.'' w ygo�ywn AO •1a'--•AP•• � A �..-,•Ao ,.] �O-'$-'�" ' `ZM N '4 A: A o O n' L2 .,-As P.b O 7" •t '.'"1•A A w w .n A 5.— •N*'.. ', •AO Et' 4« -,� lTIO •', 4 iS•� •r wA• Co ,"qi• 'C7 O .2 �!;y ,Oy.p• 'n CD'd . ..ti = 0.. -.n • w OR 'O a O ....2 n •-.W O .+.0' a«n O < CT • __ •.. q ..•. »,go ', N ,sw1n �• n ea --o' + K " a �De1- g.g �1 :•� 9 • :0 ,.. .i K tx aO..13a' p,fie*A o.c. ..A w .'•ewn�0ru _ 3 I r ---- 4. O. 4•.- O_.s ,wPt O'O'el. n .4 op E."q „„ -. O fi' So 7,,0 0 00. •0'= f'f E• w •»a`o ,�' :•p at -" 0 p p W it o < w ..� [c a o " e4 a co u' 'w w`4 =''' / .,. .i..q Fr woaw eoo N i.'�-, Ai. c Q'oeD'dw 'i,RA oa {x.C'" 00 P. xi 2'r1>" '.5'.�o�a' a, p, ..'" 0p"� .z.." . 5ww rvp or, cn -oiWD , ma°'yo= Cur• • m. 1s7.•p.op J•0 w n-sy r.Di, O ,rs'D tl "'n n w.C O ry.ee '' .' a, 0' fy'Ft, NOR a tro., ", R • o 'dCa p- '17Oro• nw•..A •+ xA»hiu cb � boam,'a' � o�� o ° ,wv�' `e .do ti$.e, v O n0 =. .aQ �O7'w ,O�g .y ., Awg,a �ro .�ep., 51'4 O.., 5p.. � 0 .Mw[l�7JSE. `4. PIa ,. .• ..n o A p•w w ag „ .*�el'5.•. ,2, .. D'g 0 .1 5'= � e N S.g n R °"a g-nf a Q"2.A.e:14 0w.3 a Ir.. ".C+74 .A p''..wC ' 5bo-y -, 0o.. 5AA -a'w '+ , ey. a•DgDy a t!' ciao OZ. pK .E; ...p•Y.w �'naK •N, H 0 o• —.-, ', 5:O . S-1AC"Cow ' ,0 to V1 tti —It :••• r6pm ` '* eo_,,ePIG;gos. ti a w q v 7, m 2 A '•t 5 N �r gG ;:¢, ,.� 'Myra .` ,,..,x ;5 A .�...�. ... O in'yG" G'Cf A 'y p •O'� a+'t� y, o.0 r.4 �v. 0 m C. .1 W-O .1. �wy d ItI ,... ..y '+ '�;Y9 •.eD < eaD 'OD "� '-, .,• 4,- O 0 1.n0 ..`.O. M m.SL a= ��, in o w o o ar » w " ,t`^ `�t a 0 -, a » C A'o v. d ..,E, G$^ ar4.o ° ;° n o a ", o .. �,tip. .0 ry w n:a+-S •s5 A G o a. A A e .,Y, 2- rvnron op., Ph* > mxa ae� ,. a53:y� o C o oo� $:�� x ° 5A +►- A `� AnA c ., w "p w Ae9- .` 0 »A ».-"� `. o Aw w Oao--w ww O w `P ."S ,:N o A , �p �a •�,e o 5 w y «, ..,o y';o o qq�* •a _. C3F o tt G5a,w.'c CO,4A .N W 't.n•owT�j0.. wt0ii_ Roc 0 wo•ew*0O.1R•O ': +'�+ Q p 7 0'�' `G•G ... K.0. "At. ••�p•+.. 0`,. W..,:a 4 a a••d• 0 9, p.=•1y ez^•D w.,ni, ,On O 0•«A, ~•I4 a a;yo o�sw•AR3 g (e. = r.,•,••ap2 T °,_wc .0 p•o 0a o •, tg� o �orrDp•o -,6 'Pr1 M». 5 A nog w tt w •t A , .••A 6 5w 'G y o P�J W it; 5.+.1 '3 0.f) 0 v