Stimpson, Marcia `, f
Form VS.61. NEW YORK STATE DEPARTMENT OF HEALTH
OFFICL4.L BURIAL (OR REMOVAL) PERMIT
tom' 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 alter the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE F
DEATH, LEGIBLY WRITTEN IN DU ABLE BLACK INK. Registered No. ?L mil
�ff` Town �i"'.c 44 f ��S� -4
Dist. No v/ County Villag
Or City ve street address)
Name deceased
�,____,, ,�/ Ingle, married, widow l�
Se olor. r- divorced (write th word) .. Date of ... �/ 19.T
3.
Age Years.., nths.... . .... Days Birthplaces/��
Cause of Death ..
Certificate was signed by. ... . , at'il M.D.
Address .
•
Place of Burial (or F • oval) ,L`'�Ilr+�4
(If body 18 to be tempor: � r eta; I I .la,ter�)�1
Cemetery ..,,, Date of rie.:414.11."Le44.47
.. / 19(C.
(If body is to be tem..rarity 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 acc ed the same f r • gistratio• h:ve recorded it in my Lo 1 rd with the above stated Registered
Number, : y h.n .e b eof I :`'•:'= RANT A PERMI i
the !... �/ to hold temporarily nd the body.
(Under Lkeerson ving charge corpse) remove,or of rwise nose of[s how])
Dated ��� f� 19. 3. (Signed)
... �, .. ...
Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State ubject to local
cemetery or other regulations),unless removal is by common carrier,in which case a Transit Permit (VS No. 62) is required.
•
rHti roowc+w N � v>an ogro wo0En t-+o -rs � N < nv 0. El O =K �� ', a,O'a �M!W'C �� '^....o ^•+.nY S n rill �s'n n O C �' .� .y a D,T p b
a 0 n n , w .w a w ow a -, n H ° o s ao �� R7� w
' Z3 a n ect waa r�o a w svN woo�C �: cso �vwo .Wn n N =-°s 'cb w H °� o-C 7C� p-a a a' Z'
x • -I w ...'o •, az ay., e'7o •ea- "o rtn enNn ny.;, �ww"' � oa onn toE ITJ b w0A
417.10tn y �yaeNnoyny ' .y °: a ,wgn°•y,n n--lo " ro � o•o (" o �.o, ' n �-4 � °c, zw n °" 0
O tri w a,,, o, „„ e,, o m n ti n`< , - con p•...,y rt a,c, •n •, n a a'a 2 N .:N
.N•. Ck g. n n O 0 a w v' 0 n re • Fr, [Se ' , re O •a.,..< a < A.n ,a'.,.,-.N p CT' V O v
•, "4 ..3 0 5 es a°,2 a-o a .n PO y w n o *w 6•rnN 5. "' e a .a:`n N o 'o'n e w o M o,=cco , .41
r w 0•a., a n n z N - no re v o », *so Coen � ,1''M� a°' < a ^+ n a : 0 -X zHGa' CA
CA
2 0�0 ...N 9 re a-5•s-+ s... 3 n < -e C .., n ��^ • ao g`‹ n n a• °'i •M ° "d
0e 2 n . °:n aE rs'w—.§ w e F•e wC *R'd C.o d• 1 n N' en rt-.x .••--...,< -, ac B • man .7a
r....N , .t+ nN n cacao �j ro � Haft wnn wN � �Kw A, N. �n , « 0 .. Co-
•
r° p n Zoq a'a n a~ a o . A _"'C.
/D A' ce ,., • w' •0 g n A, w __ rt a , Y N QQ •N .A nap
D,0 I a9 ° C•O n r"2° a�,,n+•° n•C'O n w '�" n ', ,'-r.0 et Al 0 fi,n w •� ° ^ n'w O N a ^ N M 2T�O
'� A. Eli r.. M N N n C ^t w ri C n T O rt ^, 3 '"'Cam, w a `^Je 0 M A
A r C EnA'era nro " N a • —, Cra o.?�. •w », rt_ e�•< ,:-... ° o n >° r"+y
n n wN aawao , 0' "Cro H!F
Hn ow .anNn s5 wo ..wcr C0 A• g•° o•'" N�•nQ•NwTwg < •, p° cHp G"p'OqM0»d oaN�=a, .1 aK-'OwNO 7i's n A a ��Wna.Np " II' nrwa„N O w <- 'P. .< ..,-. PT. N p nro a +ro •fix Sn _w _ v �,•� e77 a w •, n a D .» w n s n �....••o7n Aio .q'? p R .'.C, ti i: IJu
W a0 a., 0•�fD p.a��Sn .['i .` ° � o y H .°..� n �.S•Q p•n �•�b "'� n O O M �� ��• a'[� N n , • 'COT ru4i.1 ° 5o tia" E .en R'!D : p n 0 »,s ep '' n o0 '+ ° g n ° a = o . CD0 co sa» CCo po a+ 0 A M =►3R.. 3 °""�
• Tl a Cr n n o •, cr as Cr w O `C: ro -,
a tn"3 :elw �. n ron .nn n ° ° ° a " ^ro Cc '��in nDa._. o- ° � TS O'�O
"w ".a a `' »,n n a" p, xy R-0 ?.-1 �•w•n n a 0, n N w�. w�rtY�a ; �.* n` t' ••C �,`"�'
a H no• ETo.p:°Q ,„0.5 B o g"n K w 9.0 n 0 w a ° N s , �'.CD rta .. M.y traz... unrr
. •rf„ �. ., n p•a 0 , ep �,., O •'+,y. O N .w.S'Ca 0 ra n N H `� N A •, n n y W O
N Q, P•Q,y -n_1a
a"�7-•3► �na,d ❑'^�'N a•a•P' G •, .°n nx-7•'+ 5'� W � �'C p•t° Q.O n'�' N ry •, aN p aw(y r,° ^ ° P B �a rrN
'nx5' anw w g "i° an ro ,.., »,a ,.,, o cn " 0.w •, , „, '�
O m�°p Ss. ., "aa p ,3° w n N•o'5 5.ry 7 p w ° "'t •i^+ n, n w O0 0rj2 d $ PO o Z
22 » gna•`O' B-w .'“? `,T,'.-° -a4 000n � °e Nne<°, �0...--3,wa0Na��° =_. a 1-i �n1 .:•so 6 yA
CO D' n 0'A) ^,� w -.n ti re a•„..w " "„i •, •„ �.,sf' ° O r.�•,o n va, ^� •°ti ~` p »,CT' •C 0 O C M
O 1�1• `1J0 n C .. ^'.° SN n a w .°, " C.y'y aN 0n w ary 0 C R n�, -,Sw r°.0.re 0 > 0 0 AA �►p�
e9 •, a „ .h +.0.,1 n .•' n os n f° C W a o F.„- t n n .n, G 0. N N
"3Ct14 H no re - n ._.an .0 n •. , s n ., g ° O0.Ep.n .,o 0 r i, G.�O
n •�'„nN C N• a""r`n• `' O t' n a N M .. "'FM w p n
]^ "o w 1 S7C' n n n n N a•a' �. n ?' 4 . + o 'a:FM ~ro N y n H� .i Cr7Cr12'
O n A ,�, n SQw•K w r p ...nOR ,� Co' ~ a ( O ���•j,, n,-f9 o'" aKer7nea° .0.0 ° R
;IF. Om K -, 0AnO �'d .," .°.O w,,,' 0O"roeq.A ..n,aE: rvn3N•a•E W Ftp:R:p."3-" AC�n Z1..
ofi�.. N.n .y n,b O fy .°+.O='r� .`t. 5'a NEt.:',N n _S •, y 'rt C a ,�. .y ,C A n F. A a•�, _ "1 Z
i• BoNOn -, n ro ns ti o e n B n Nd'v - e CA
IV
w ��A oC . P,a, aC:a r"° .-I nm0a" 7y'O•°.�r+"1 N ° w, c70. wc'b° y .°.," nn,vp rb A "tS
w A N y ft n. 113 •'e, n _ N a C " ,y ,..,N •, n n+A�1 A
• o w -' .° g,owoNn �c:..' ., n roo ° � '* onA � o< ntia;�t"" x•o �• O�
.r25 nro � ° ynaa'4ro= — a -cra0 • 5 at •5.�•, (.1. aaP6'° = 1 o Y. '�
., A2a' 0n 64'8 w py•rt.:° 5' 0•e� o� C� .n * 00.c'' 0p 074 on o H`^"
A 0 A ', �a rSn �.. n .r, O a'o O a •< n N n "C.N n ., C.N < " p1 "^ .•p"K
O 0"J XA .:n n w.n' "b w a y'� a C b ., wf rt w" wa Acr.„, Y■
N Q oa•C a " c,.. C•< a n0 .," 99,0q-r 3"Eg08nne .; wo-'+o e° aa t�1"0zCT1
20a x"•C,=. °a' "rw'°i].0.x� O.g. wr9 wwo•.wy ^'� asfa 00 n0..C-.•d NH ° K'o ---, ..'O+ liy O
R.�ia 0 a a-•..w g- . - ?.•8.A•° 0 -.y °al o'.•.=' er 2 < Z ee ° P." c -.. N G' M