Ingalls, James BURIAL CERTIFICATE FOR CREMATED REMAINS
Issued by
MOUNT AUBURN CEMETERY CAMBRIDGE, MASSACHUSETTS
I hereby certify that the burial permit and the medical examiner's certificate prerequisite
to cremating the body of James Warren Ingalls
late of Northfield, Vermont have been duly presented, the
same showing that death occurred at Granville, Vermont on July 22, 1947
and carbon monoxide poisoning as the cause thereof.
Age 60-1i-28 Date of Cremation July 28, 1947 Cremation Number 19309
Date July 28, 1947 2id ,r
Superintendent in charge of unt Aubt ,C,Cemetery
.-4
C1nntntonutealtl of 11a inrlluoetts
Middlesex ss. 19
Then personally appeared the above-named
and made oath to the truth of the foregoing affidavit by him subscribed.
Before me
Notary Public
NOTE—Acknowledgment required only when cremated remain. are shipped out of the U. S.