Finch, Gertrude Form v s. 61. NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tar This Permit can be signed only by the Local Registrar (Deputy pr 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. egistered No.
Town
Dist. No Countti' e .
` (If city,give str ddress)
Name of deceased }.. .
o?�5 Ingle, married, widowed,
Sex: �l..........Color <Aliar divorced (write the word) 6 J Kr' Date of Dea ..a) /Di 19 �s'
Age i Years 14 Months 1 Da s irthplace., e -4 W!/
Cause of Death .. fir/
Certificate was signed by -27''''' . .Q-'✓t.. M.D.
Address ��;..�c,�.l� -�!. t � t ..
Place of Burial (or Removal t /- ....12-7.-.c.44....4....,...u.� ...
,
(If body is to b to posarily hel Sill in space ter)
Cemetery.... ..n(u ,.... ,..L.LAA) C.4.4.,t,v Date of Burial 4 1944..
(If body is to be temporarily held.fill in space later)
The Certificate of Death containing the above tated 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
Num and o e b 's the ti ErRANT A PERMIT „ s')/(
atj
me) P/ �' (Address)
the � to hold temporarily and� �' the body.
(U ker r person having charge of c zpse) (I t e otherwise dispose of[state how])
Dated ., . // 19..! '(Signed) ..
Local egistrar-
This Permit is sufficient for the Removal (and Interment or Cre ) o a y to any part of the State (subject to local
ea neter0 nr nther raanlat'innsl_ unless remnva1 is by enmmnn carrier. in eh VAS n Transit Permit (VS No. 62) is required.
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