Burns, Gertrude BURIAL - REMOVAL -TRANSIT PERMIT
Place of Death:
1 FLORIDA STATE BOARD OF HEALTH
2 County_Hillsborough BUREAU OF VITAL STATISTICS
W
a. Precinct 1_�5 4I
z City or Town Tampa NUMBER OF PERMIT
ttName of Deceased.._G_er_trude.-_Ethlyn_.Burns Age 50 Sex_ _F Color White
Date of Death _ July 25 ,19._4$ Name of Cemetery or Crematorium ..
W Removal to: City Glens- Fall, State New York
I hereby certify that I have prepared for burial or other disposition, the body of the above named deceased strictly in
a accordance with the laws of the State of Florida and the Rules and Regulations of the State Board of Health of Florida
E governing the disposition of dead human bodies.
mFirm NameWilson Salmon -Company (Signature1 /l License No. 362
(FUNERA DIRECTOR)
to
m A death certificate having been filed in my office, permission is hereby granted for the burial, transportation, cremation or
< placing in vault (cross out words that do not apply) of the body of the above named deceased.
Cc'
(Signature). • 73 A#j Local Registrar
mIf the body is embalmed,the licensed embalmer is required to file an of iida' ith the local registrar before Burial-Removal-Transit Permit is issued.
tit
The Burial-Removal-Transit Permit must be delivered by the undertaker the sexton or other person in charge of the cemetery where burial takes
re place.This Permit must be endorsed by the sexton and delivered within ten days to the local registrar of the district in which burial takes place. If
m there is no sexton in charge of cemetery, the undertaker or person acting as such shall sign the Permit as sexton,write across the face of Permit the
D words,"No person in charge"and ret ermit to local registrar.
WIA
o on 7 ,Body was C 19 in
STATE WHETHER BURIED, CREMATED (]PLACED IN REC I ING VAULT)
_R54e-e.- Ceme � �` ` it 4e.fiLo.
y ..._State.
a.
(Signature) ✓
- cc (SEXTON OR PERSON IN CHARGE)
F
u If Body is to be Shipped, fill out the spaces below:
W
m
Shipping Station Tamp , Florida, for Burial Name of Cemetery
✓ (STATE WHETHER BURIAL OR CREMATION)
W (if obtainable) at Glens Fall, State__New York
T. Consigned to__Sullivan & Minahan Funeral Home Address 67 Park St,Glens Falls, N. Y.
O I hereby certify that I permitted the shipment of the above named deceased this 28 day of July , 19-_-48
(Signature) rE) ,T* TIA-C-Cz",GE Aran
(TICKET A { K
Shh::me of Transportation Company T ""jgiw Earl
.«., IviinAiL2TEA_ i
•
•
Rules of the State Board of Health of Florida Governing the Transportation of Dead Bodies
TRANSPORTATION AND DISINTERMENT OF DEAD BODIES wooden box or metal vault; provided,that the body will reach its destination within eighteen
(18) hour.,from time of death.If the body cannot reach its destination within eighteen (18)
Rule 1. A Burial-Removal-Transit Permit issued by the Local Registrar,his deputy or sub- hours from the time of death,then the body must be prepared as pros bled by sections (a)
registrar of the registration district in which the death occurred,or the body was found,must and tbl of Rule 2.The outside case may be omitted in all instances when the coffin or casket
accompany each dead body when transported, is transported in hearse, funeral director's vehicle, private vehicle, pri,ate railroad car, or
(a) The Burial-Removal.Transit Permit must state the place of death,name of deceased, private airplane.A body to be transported by any common carrier must in all instances be en.
sex,color or race,age,and the date of death,the date of shipment,the point of ship- cased in a sound coffin or casket and enclosed in a strong outside wooden box or metal vault.
ment and destination,and shall bear the signature and title of the Local Registrar who Rule 4. In the shipment of bodies dead from any of the diseases named in Rule 2, such
issued the Burial-Removal-Transit Permit. bodies shall not be accompanied by persons or articles which have been exposed to the
(b) The Burial-Removal-Transit Permit shall bear the signature of the funeral director and infection of the disease, unless certified by the local or state health officer as having been
show the license number of the fureral director issued by the State Board of Funeral properly disinfected.
Directors and Embalmers for Florida. Rule 5. No dead bod) shall be disinterred for transportation without the written consent of
Rule 2. The bodies of those who died of smallpox,bubonic plague,Asiatic cholera, the State Health Officer.All disinterred remains shall be encased in an airtight iron,steel,zinc,
glanders,anthrax. or epidemic meningitis shall not be accepted for transportation unless pre- copper or lead lined coffin or casket, all joints and seams hermetically sealed or sealed by
pared in the following manner: gasket and all encased in a strong metal or wooden box; or the body placed in a strong coffin
or casket and encased in an airtight metal vault or outer wooden box lined with not less than a
twenty-eight 1281 gauge metal lining.
(a) Arterial and cavity injection with an approved disinfecting fluid.
Rule 6. When dead bodies are to be shipped by express,all of the preceding rules shall
(b) Disinfection and stopping of all orifices with absorbent cotton. apply except the Burial-Removal-Transit Permit shall be attached to and accompany the Waybill.
(c) Washing the body with disinfectant. Rule 7. Bodies deposited in vaults,public or private,shall be prepared in accordance with
(d) The body,after being prepared in the above manner,shall be encased in an airtight section(d) of Rule 2.
iron,steel,zinc,copper or lead lined coffin or casket,all joints and seams hermetically
sealed or sealed by gasket and ail encased in ■ strong metal-or wooden box;_or Rule-8. When a body has been held fifteen-1151 days from date of death,permission of the
the body placed in a strong coffin or casket and encased in an airtight metal vault or State Health Officer m-st be obtained before the body is offered for transportation.
outer wooden box lined with not less than twenty-eight (28) gauge metal lining.
Rule 3. The bodies dead from any cause not specified in Rule 2 shall be accepted for
transportation only when encased in a sound coffin or casket and enclosed in a strong outside
INSTRUCTIONS TO LOCAL REGISTRARS If the body is shipped by express,the Burial-Removal-Transit Permit must be attached to the
Waybill,and the receiving agent shall turn it over to the receiving embalmer,undertaker,or
Local Registrars must keep a sufficient number of Burial-Removal-Transit Permits on hand person taking charge of the remains for final disposition.
and order additional supplies when needed from the Bureau of Vital Statistics,Jacksonville.
Burial-Removal-Transit Permits are not to be distributed in blank among embalmers,funeral Every outside case holding a dead body offered for transportation shall bear at least four
directors or any other persons,but are to 1,kept by the local registrars, handles and when over five feet and six inches (5 ft.6 in.) in length shall bear six handles,
The local registrar is required to fill out the Burial Removal-Transit Permit which must be _.two oq eat side.and.orte en.each end with approved bolts and lock nuts.
signed by the funeral director who prepared"the body for ehfpment. "—� - -"-- -- _
Under no circumstances shall an agent or baggagemaster receive a body for transportation
INSTRUCTIONS TO TRANSPORTATION AGENT OR BAGGAGEMASTER when fluid or offensive odors are escaping from the case.
The Burial-Removal-Transit Permit should be placed in a stout envelope and attached to The coupon at bottom of Burial-Removal-Transit Permit should be filled out by transporta-
the outer box or case and at destination turned over to the undertaker or person having charge tion agent or baggagemaster at shipping station and mailed to State Board of Health,Jackson.
of the burial of the body. yille,Florida,within twenty-four (24) hours after shipment of body.