Akins, Clarence ni VS.61• NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
t 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 CERTIF ATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. ` �� � ffff egistered No.. ,1-,/
Town > /`��T�`'"•44 ratie4 Dist. NG..Q�I...County Villa • �••
g� (IP city,give street address)
or it
Name of deceased . .. .,.
Single, married, widowed, ���f�
Sex. . ....ColorW .or divorced (write the word) G� Date of D � �®if 19•••
Age Ye rs...�j� nths ag.� Days Birthplace.. A ! ...-
Cause of Death.. . .. ... . .. . ...... .. .. . . . . . ilef :.. .. . ... . . ... . . ...
Certificate was_signed b ... M•17
Address
. .. ... . . ... ..
Place of Bui ial (or Re
moval) . ,' j.GL te:C. Fv rAb•t
(If body is to tem ri y Id,fill in sp e la )
Cemetery,.. Date of Burial 19•••4•13
(If body is to be tempor ly held,fill in space later)
The Certificate of eath containing the above sta ed particulars, having been presented o 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
Numbeta ltl o ie b Iis they of H REBY GRANT A PERMIT
to �' iae-Gd-e-,044,7-4.44,-2 ?-1
e sa)
the to hold tempor n the body.
(U rtaker or pers h ving chargeco pee) ,remov or of seise di , e h w])
Dated.... k, 19.. i (Signed) `� •i t
Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation a o any part of the State (subject to local I
cemetery or other regulations), unless removal is by common carrier, in whic ase a T nsit Permit (VS No. 62) is required.
go
cri i4 4`•,° n a-O't e M�64 0 0 A »..:_.0 n•n•°5 0- r'O �_o g � �-a ; < o9 r2-°:3 `"�'f G ."3cn • •,�,�
tr n " oaa '^+ 0on .nwemC0-?; w -'c ..o pe 7" n0 --npya F.. ,cn < 0 Cn C
n n a"' w p '1 w ?y n n '1 .-'n r < ^p .n ro " iD �n 'ti�. p
2 i.• a , a n -t a 7"n n ?' f07 w '1 a•a W'^t O a 2 -+ v`: C f1 A{IQ •.
71 0 41 w . o n a a W.5 r% "•W y...o• a• ro < T•;c 2'i". n N `+ r ea, •') Pm tr+ 0 m
O II `ea'< 7•5,) " n n '1 :•o ••v a•cw^N42 -"itow ,� = w 09, 7, ..:5.0 ^ tnF .b y 0 m 's,-
ri.,�1.p, rziUf . . .. u u „' a a n w c.n ,••.V^n '1 eo- c ''00 it =•b rn p•w _ ay ti �zK R p O. 2.. 0
y0 x n rn N ""° '•"w z w p • N n0 .1 r aS C�ee. ~•^..y , el ° ° w ., '1 a •J• 'J C-w N sL y,-,p O
.4 'o' n060ro oaw, n -I wo *^n »N- ° Ca» .- E• oQ:.3w n °. a' L., c-p cao ..
07'O �'S CD o'a-°.-ni o-^o 5 n eD_ ., *o o Og.-n 7`,• o• 'a.w a •n, ran 0 ° o ro>C 7ztn VS
m 2 0 »n E C,?r a w ti » " w c• *0 c ..,-,-, C C „ C.w ao M'< -, 2 ; t-3 A 0 •ICp - "d ril
p Orrw U) n ."� a�•n .-.•n'Da `< G nm W '1 n .7h ?Yn
g C"o ,, z •G , m .— owns .c ', '•-3nni � wnnwpyg w "'•a ,,'''^� r~op',o, 9 p .- /"7�
p n oQ con a'+ m X o-C- w 5 ,-.w y n o wt.
t
,, ypa w ° �•0a0.ac.wno...' 0 rDC4 .n,•-•a 'arn na ° n.°:. E°-' o " C KnC� MCr1
m vA' y� z " 'n", r'•'4.0-I&' ECa enw�.. aw52e-e- c �' Eo ,n+"r_ nP., •,,n ? 0 ••,w' .�i�'
��71 o co nro flii
co
ro"..851oo.� w -t ,1 ,7, = " a0 OR.0� z ��O
7D a as o11rn c no, •- x° gre wo a - Q y9. p Ca-" • cn4j
c..1 n o .. " a o n r:+rn 'n Cr " n 5n a n cw 0 L"77 ••t C+f
0 5n w o " 0 5 s " 5 " n p 5. ,.--❑ w w n ca n ..., , ' o o K ^'
o -3z� cw � � oroo � na; o c^ 'rn � wn .. � a�r» ann n " H n0 < n EOrn
0 � n o � o ro aoon � nm ov ° m arc + n0 nptom „ o
0 " • ro n a w K ., o' R n c �'s5 n'o R I y G n Z CI
y -�ri�CXrI � yn �' n -°, nGOn ° -� � � 't p"� Dwo n 0 � '1 ° o ' w_° r° 2- • Cr1 -p 4 !t*:4
i !i
ro n »n nQnbE 5 F m �° " n raro `:. �C nC0O a3o�•w n u, ---ni' m - ---es 0tw J ^ C ---r _
H n• .w -, W •o •o rn -o o c o " R .. ? B tr tt to 'v CA A
_1 0 ^ o < w 1,1 o =u, n 0 5 n rt. ooa 0" .°, `" 0 y ^Co" s� y n w 24,m �. n
..may ��ado'--? awo � o ; ] -n, man » f •-o.`n° o,y �' " ,,, 00N,crF., "^ i7r-Ioa �.�0
0 ��0 0' QnWpY C .n " oe an rp-'T ww ao ❑ o C ° ^ O .._.CLC t :: 3 •A,..�7
; ZZ. 5-aZ'oa•w wnx�9.,::rg4 onnnco �n eH <404fl; '"a • a-074n -IC C.y m�rtmc 0` o ITI.. "O
tTi
ett11m nc o " 07 n5'yo'd rb>d9.w'.-... rr. Haro < ronH »,a ° 5" °.,a•"'_ 4 MI,ecmmo . 0 m,,
" » . rn u v v' a o rip w �s 0 0 .4 .�C�!
rZ• Zw n n NTrtn n au' ro',� M C _." .1 " ro ;7r000 •pppm .�/"ti
3 � Eno 9c w� •'0 ° gnrn o Ernes w00a. o r° " C0.y i :j
^_'..•�; << ., wQn � rcw o -, a•. nnro O nV " .aS .° roORw 2 or
-if
a Gam eutwwo;I': rm`o nNma• 3•�roo•re ' w- yo5w ^a wn wo- oa (n X0.a
F
•re 5a a-. re .;oSo,A ..,a .. .. m_ wee *oa •,:^.^.',- ar„ w , 0 »m ••
'."3 70� 5 rno '. ...w y w ''a,c w " w.. a0,o " -t o•r.t.w o 2' w" a" a-w xitr 1 0
tf, c E0vc5--4.,,,.^rO� 6D ac anroy0 52g,0anrr, v, 00a•lu°.' ro a 01'0Z Cl
y a ice n < o n ^ o'y ".y 9 w `� 5 ' c rGn • •a w o 0 5ro tv0 0 c0
Arcs~5ro3 ^.°a �" aoy y ewa'P ��< aNQao tia°c �'1, N °= co � RG .
�' •"'a °•o n .0 w to 0' o' c'0 •n < Z n o ". n x.. < rn W 0 x 5- O
C17•w 0re !Ian � rewm5v, � " n ." =n SrA " o•°•woa5 w4 wo•».4 a a.n= •-'. �5'