Briggs, Laura ..,...riv.c♦u uv,,o Lv--i itc4.l.\.YU 11.0.GU1U,l.l11LULY - kti •— HCr-I
ca C 7
OFFICE OF I raLERK No. - i;o
lb �Dc
?N
K
BURIAL OR REMOVAL PERMIT of 3
Ei;w
/'j ao m
Newark, N. J.,__ S� l J 19 _ rtaa,
The Certificate of death having been rnished rnished me, as r``ehi ed a laws of this State, permission T=�
is hereby given or the b ial of /� Z�-- ["'( f` . a
pf-p
O�l a rtwho died at `. ./.1 19_ °"
— n
1 k I Years IMonthsl Days I Hours I °o m
S1
cause of death being__; Age $ _ .) I`� 0•
Place f burial_ -j//-(4- °3
-mA
o,a
Und taker or ers n in harge T` SF�
_ _ CITY CLERK °�F
nT
'3.to
Penalty for Burying without a Permit, $5 to $100
, .
i•-• .. c,,,,, tt, to
:11
0 a
. ED' mi rri
hi
II
'4
'-<
! r. 0
:: cbrl . its r-
rri
os
, X
,-.
1-3 .