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Crandall, Vira Form VS.6L 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 Prat- ry 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....5.6Di..County La.rr..en. Village.. 0...Ho.r.i.aa.Cl... v.e......Glana...Fa,a.ia...N. ... or City (If city,give street address) Name of deceased Vir.a,...i i..7. ..a..0.ra.nda],7, Single, married, widowed, Sex.F'.e.ttaleColoab.i.#,.0 or divorced (write the word)..i&I:.I:a..Qd Date of Death...Jalla.... .t .f.... Age...7 Q Years 3 Months 26 Days Birthplace C i nc i anatU a Ohio Cause of Death Grade 3 Carcinonia of Recto-Si;moid Certificate was si ed b ,-- Fr I or M.D: _lam 1' �..., .. —--Adaiess Glens Falls N. Y. Place of Burial (or Removal) Glens Falls I .Y. (If body is to be temporarily held,fill in space later) }� Cemetery ?'.a. @ Vi.gV1...OP.KIP.t e .i ry Date of Burial sT a?7.S:h:a 19.4.0. (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 5g.m:.d...TA....F.o.: .t.er Glena..Fans... I. r.. (Name) (Address) the Ihnde.rtake.r to hold'temporarily a :Inter the body. (Undertaker or person having charge of corpse) Inter,re o dispose of[s o `ski �'7'"C Dated sigau....2.7.th 19�,©... (Signed) 142� F ice This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (s ject to local cemetery or other regulations),unless removal is by common carrier,in which case a Transit Permit (VS No.62) is uired. r yi "P_, B.a err, 5•� 0� fto ma «o, s a:8,TttgEl2 Fal �! ^ «« tvi M pp .� 1�� [.8.0 "e00N g.' * x'°"'"is " 1 4 " " °°° toy sP x •'•x¢ � p�.p ry A 4113 a •'°•W , ° 'O, iliwg, P. LI !w A ...0 A ry6.�; °t�0,W g • rp W 1! " N ^ .w < - 2,. —eow •' ' "' aa .aielse0. 0XWt1.,.. &oae,arow ., 41 = E.,2ate, S:a•3^e2 N it C8=z ,a 5'j=2 w . ..4 LC **Ae+ w ,• a N +i��E.gcr,..•aed8,,0 $1 11E644. ul ei "0M M a �•R h a°. " �,W,ii o , "" O a.a E "Ps'og8 .�C g w 5 e � `s ,,,,,,� a eC tt d C° . 5' to m a'':—Pegp ..p• ° 7 ow �Pr '''s'rif'4i.< 5.o Vj 00 tlp .. 41 ... ., r . _.., • p +i a ... 8 a r: O tr7b ° ,..a P �p o N n "q p a 0 C N 0 9 � "rfrz ' 8 ...�. az " pO " a--a ��..,c' � p, w " < p FO 1'O��,, x 0, p,�Li —E3 '� o x� o {� ~ " o��iV ' - w • ,, .tIQe��ff ..."p,A 34 �i,,.. C a, ulg o , O vA 5.I. gis- Qi •'o ° ga 6'�- `" ° gai; 5�owg-""° a•s"'goqo - x 3 PI 6' 'i , 1 Ci� ztri 1-4 wr rl � ° i " . ; iIi '� .9 " 8� �4.aS�-Xis" e,:o E ' p. eq O'.�O e. g• _ g or Z ....�� • Ni a 5.5..1 N a ??s+ C eJ a -, A w .. p • p. :. • • $ " a-5'.w .w. 5 a" " R. aa1•o+3Pg y <o �°, " �"+ca.d?.oer �i � glut8 .a z.d z °r^ [$ w11',Ie' °.pb °ooati <° g oaao G5 5:0•0•e i, ...° Rls. Iron 8 I. 1, . HM ,� ao. p =.a " oa• �so'd biE:::" Ii 1a1iii ^ g, :,,w" max cr..or 4 _ 1 . ` 3ti"A � 1 4 .'i s ..,•`S.,',N a ..N,.y " n N. Net. N p. . a " 5.of ..a .ay C• A ��r(/1 .... �' A0r...1.....° C °.,. 'C 5•N• `, og r " ga a. (4 40tf N !' O .'° " 9r..► a ee 7�1 •, j1Jt �; n e► O. : & •1 M x O i O~ j a .q .w a g p M N o c•a OC .i,4 a " E n� �... o . ° N . 2,0 as a •nSE N O p " w .°j." .{Ny p'n.� ham.Q ",M ..� .&'`-'241 g c 0_ OCM ON {/J .0.11 \' V� �� FA al� F -1iiiJiIEEr tJ•4k Tom'il •�^y '*O A w .y Eby C,N ! •ai O N i°y.. 07 ».�R' 2 a 5.R0. b " s. Ira 0 o5 � $N :c a pa iA$ = 16•T a ` ... -.^ ° we° $ 0 '� 4 . � w'� ^1C es p0 k , P.o1) 0-.7 •aa P O0\