Weightman, Etta Form VS.61. NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL`(OR REMOVAL) PERMIT
tr 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. No..5.7.h5 County Washington Tome Fort Edward
or City (If city, give street address)
Name of deceased Etta Mae Weightman
Single, married, widowed, Parried
Sex..F..e�tl. Color W or divorced (write the word) Date of Death....lTar.Gh...11 19..46
Age 77 Years 2 Months 12 Days Birthplace Rousos...Loi.nt.,.11.Ys
Cause of Death Caxd,iec.,sle.caxopeneat .on..due...to..hypertension
Certificate was signed by M.L.favilan4 M.D.
Address Glexis„_x+,4113,N,x:,,
Place of Burial (or Removal) Eine...Vie.w ti'eJ71....Vault.....Team....of... ..le.ensbur.y ii..tl.
(If body is to be temporarily held,fill in space later)
Cemetery Date of Burial Kay 19..46
(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 IaI'old...C..Staf.£Qrd Glens...Falls., 1..Y..Cem. Vault...
(Name) (Ad ress)
the Undertaker to hold temporarily and remQV.e....rrom..Union. the body.
(Undertaker or person having charge of corpse) /' (Inter,reprove,or otherwise disnose of [state how])
Dated lY y...24.,1946 19 (Signed) l ` . .i'.'
~Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local
tery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
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