Loading...
Baker, Margaret I'Form vs.61. NEW YORK STATE DEPARTMENT OF HEALTH • OFFICIAL 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 after the FILING and acceptance of a CORRECT AND COMPLETE CERTIF)CATE Of DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Registered No. © gel,\oiq Town /1 ,, � r C Dist. No .t!�.County ' + Village (ror City (l city, give street address) Name of deceased "4 A r` G��r re U. Y� e-r Single, married, widowed, r , / ,'p gfA / �J (fit Sex ems,color- T V� n or divorced (write the word) ( rr 1-`6'` Date of Death 1p r��/t `11/� ` 19..Y.41 Age 7. -years & Months /, /Days`I,` e �/ Birthplace..Kid—L A. vie t►'' ✓i-k-v t Cause of Death COr0►�Air f<C0-.si1,N06),... A'a .. V A'riert0 ,Cif rrti he;4 r GsA-4 e /`}-f :-er trcate nits signed-by • t- t t+ CA.�i �. .. 1-I.— ( ...er t. 0 r A r 1. I") t ti^6+CO-Adc Tess Pt A , V r 0 v\, ... 1( -l°t rG p t- ri I'b c Burial e of Bul i or Removal ) =��P 2� �l (If body is to be_t poraril�• help fill in space late P. Cemetery. por Date of Burial // 19. 5 (lt body is to be tempprar' y held. Gil in space late 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 an cep the b is thereof I HEREBY GRANT A PERMIT. to etiurd � . Po uter v 4 arren t. ,Glens Falls , .Y. l3 38 (Name) I ter (Address) rhr" to hold temporaril and the body. tUn•!ert::her or person having charge of corpse) (Ioter, re ova r ofY�y�i dsnoae of[state how]) -,, _tips ..1. ..1Qtl. 1945.... ; SiLTnedj... : �1. . / �'�-' , Legal This Permit ,is sufficient for the Removal (and Interment or Cremation) of a Wily to any part of the State (subject to local cemetery or other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required. r w w • _ to ; ,. " " cC co <oa c , 5w x� s "w I. T o H' ym a Ci: Y3 n r"J ra.• w •"-, 7.: A?y -cO,C O:w n-F .=097 .�,rt• r', ` P. H'`rti .- ""O ,�^� in w, CG �m p-4.p A 4` ��� es°5� � ow'� _'•coWo S� ��?o�° d��� � �� � w' �a� —R� '1 .1 . _, �' O " rn u N _ 1�y .'17A p9 w n w w n.N p " ,.,?� - v' m �n " •: r'`0 .< G.^• A S:'•,-•=G° < c' O O " T v� „r, _. rilT'^ "a�vO .... ,J '„� 3 fl D � rv �oa • .n �e. o *� 'o'oti - e , vc•�, �•< ro Box n ti '.w° -• o , ? *0 -, Oo-- 7�w - ° , c"D a., I ;o w 5-w — " .4,,.. C * V. �`�va " ° v y �. ,- a:°,' ,� 9 = 'o =-<T �7 Syi U1 " " M.�• 9 r^ o -, ,-jr, , : P w 'Dv ; v (c ^. = 7.4 —. *> •D A nUA� M� r 0 " z '< a2r, a." -' rt A Z� , E; F,- °1 Oa -. K�W n •,• " ' y .1 '+ C• m 'o -.o , ro a,w ,, c ._,.7 ,, " . w o a° P o'F t-,,'P o y' ..,f1 ., a z-„a0 , �' i �� o.. o — row G., cvwM < go•,,, < -�ro � vz -..w� O D.� o °aaoO Co, ""..] �o " N a�w c cr^ ate ? .. - ti 3 _ (/� �v 5 IIiii a 2 - —° c'c-c c "<•cv' , v o C c °oDg� ° n. " � Fe , =�'c G zx." r", — a co._° ^_..IT ,.- �.=„ �' ' ^ ,*. •e O y, IA f!� Lie t'7 ^"a•ao0 X. o o cb c co'o 3•ro ro s�w R^, w ^.c - ^?n �. ° `r7 + p'r` m ' OiVi O S ?' O " a. O S.:' " " N a' '� W 'F- i:'p O " a' `' ...-A' n:r a n.+r' O —I I a Ot U7 f D •G �, "' iU�T: —-,.•-] ,D ^ _m ._ w a.p o rD . _..r, rn m —rD rD — ..... v.. -- " F'•.. , .-•I a ! x z> ac O GO Sb r.v, -- w ~ �=n X ".w w '"-:''I •O p S� 2 g� c G»,F r" ^ C- •`,i -, Z I B'A >1 a n rt ...1C�I r 07C »Ja ° .o " O SO ,,, " n O " r, <'n r� r ..., Gt',O m i :.1*K =t ' ."•1 I ►. D7 ,' " - wq * 2 ' " p 9 ,1 Oao0 O'n' R'.0 °aoKCGr CFr ,,.." r '� £ riP o- ,, fD tO►=O Al r' n .""n �� r -, c' O i TO `D' z r•to .O --. " z' -a w ^ " _" O yr T w a.. r .• ..•< _, I 0 ' I yh7 _•w 'D.c ❑ P'~'rD 2, a.4",` w N.w :r L r .^.r - C `^ "ae o`< C y yam'" �-Q•f'1.w'v =` " u r,O I "1 V1_ O a..3 CP ,..'y a n•0 O a' _..Ri -.• = O ri p �,CD 1 M 5-O.. h S= . '1' m n ,!"'..+ i O .• -a,•':!+w p▪ < E.t.a o rD r•'' rD O " x 5-" c 'v, G-_ .* :i, G cr _ v , �G 2 2 m F-G..,r. F-1�•�I° . 7 w� >.I�.r I74 `+]`"I •n a O a C-'O " rD 5•" CD rD w w —N a 0 " X •", —r ^ 0.r 3 �'" ;• - IDv I S'"' a c .' w _ O'^ 5•fD ° = =t P� i, R S. ' I ZZ.. 5•rD Sp a.''�a"�r0 O , -D = `'' O O N ,a, < O r tti O " —t0D Ec a•a w O`< •O 0.N r��'a S. �"� 1rn o- 5, a? cw " rD5':w " " a w .7T po ert:-� v, c `+" o✓^] �et+y o70 4Ct76 i ,� e° cod 5 b•o ro v $ ro Dom - w 5 .�5 0 0 � lb p � 9,1A� 1 U7':<" eb K P• a•,O."],,'" '" r"c ro `u-r`�o'vg, 4 �a m g ay,' O 0 ' a'" n-. '*ro ti G W�.,� s'�" .ai n L <iv A' v wfD " oB o c D Sc . „ av r' ° aror"D0aE•p,A ... 1�'oM4 P t7 O =• °,v`D, c° '-G•9 W, 5 0'' a o 4. 2 ro rao x' " .--5 ''''ro .c»a oa °b m °" r/] roi "1 a 4 — M 7. iP.04 �° �wi 17�•arToca "' �+ a o .Pwc ..,+'r"o "' S ° o cr�or"o55'= °a„"Sc-- ,-,,, wC..7K A " dg 5'rn A?" row„* � g:=7 ,c as A' -IF B . ``; " a P.c-,w 1-?r•' A G tr �"Ir 'QOm '< " ar, rop mho " ao o $-I �M' ac rDron0 � ? w � 'Naa'C� 0.,..ep.o I"17 r•'. .rD " n"o °' w O °='m p .- a.N—. K, Co �3'•" " v,.o rD < O' " w' 'C rD ,.i .., S �" o ° o- b ° y o n -o x w '� ro fD o O °c '• ° c = w^ ` co c'a p r" 2� a A r.• tno w w ai ov no m 9 n M aq w a a•r"o w ° " w ^r, n.a a 7. ▪ E. •^ c.° �.'<> O ..0 DO�1,iwl�• z a"' G'b ?^ W-- O r �,^. 5 rD •'G Gd O'< -r°i w•m'+e,.-co 'cry' " ,: a. :i '✓,0.. r.m^' m Om F▪ Tn` o'er w� y ° a c ° �, w XT 3. nO eD� .-O rfl � ,a,m 7�0 -IP'� r D t�D R' � n p „a' o v e ,, o" A a r , n v: ,�-o r: . m-oz� c0 E ti o o " R 2 71, A G 5 O AO 7 5,—-,'G.'O W F.G.5." rn O w w rD 0 IT" +'.0..< a'C' pj< ,"� p'O ^i N G ti 5.-..r-.a '-' w -1 rl? /�• P.m$, O'Fb A.oa ri n oa w n rn•G.� 9 rr''D M`i' .=� 8.5 00 '< 9ti CS?''w.O a 7 w Oi W 5"°.,�i a a rye O I., a• J `i-.