Vaughan, Sarah Permit for Burial, Entombment or Removal.
Issued to iv)--- /ar L tL et vyz No. r 5 4'
4 County of `x.u ' ‘ STATE OF V ERMONT.
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Tow-n-or City of >V- ��
6 Date of Death �'�, -e---e----e �%Le y 2 1927
HFull Name Itl--1_.-ef.---k/ v� uG/�/�� Age' / 2
N - YEARS MONTH DAYS
>4 Place of Death / / y , Cr•-
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Disease causing death �(���
a Z Medical attendant `�
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aProposed date of burial, entombment or removal / -d-e-.7.- r-' 7 -9 ,-/ 192 7
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a Proposed place of burial, entombment or removal , ------
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What cemetery or tomb ��.=- -1'` -t-� ¢.-�z-L-� �--t--/°
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Manner of burial, entombment or removal
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A Undertaker__ �` °���� -
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a' Address /[�/�tQ--ram , d
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w A Certificate of death (or removal or transit permit) having been filed in my office in accordance with
Z 4 5law, I hereby authorize theL�(BURIAL. ENTOMBMENT OR REMOVAL) of the body of said deceased person as stated above.- 7 (- �,y 7-4 -i C;�a—ui-- c
-er City Clerk.
Date -e-z-'7it. ----- rz f?i 192/.
This Permit, if properly made and signed, is authority for the burial or entombment in any cemetery or tomb in this State.
BURIAL PERMIT.
FOR
i
Filed 19
INSTRUCTIONS.—This permit must be delivered to
the Clerk of the town or city in which the burial or
entombment is made during the first week of the month
. following such burial or entombment.
ts' a a NO. 61, ACTS OF 1923
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P.. is K AN ACT RELATING TO THE ISSUANCE OF BUR-
P.. ,'°t IAL PERMITS.
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.O a' It is hereby enacted by the General Assembly of the
a; a R rn �"�
p, N.,tt U1 '� C1. �° State of Vermont:
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m ~ fD Section 1. The town clerk of each town shall receive
C.Y m `� a' v'
CI) m' m •- 1-3 co H all certificates of deaths occuring within his own town,
aR '� a w .. P and shall issue burial permits and receive fees therefor
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a rr ( as provided by sections 8801, 3808, 8811, 3812, 3813,
fa, El o a �. a 3814, 3818, 3819 and 3820 of the General Laws; pro-
', i 6., 'd, ¢ vided that burial permits in cases of deaths from com-
*--,,i'' p - ti - i municable diseases shall not be issued by a town clerk
a `,, H 0 except in accordance with instructions to be issued by
+ , fi the local health officer or the State board of health and
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- F. ) - to be kept on file by the town clerk.
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