Silverman, William Attach part below to outer box or case
_- TRANSIT LABEL
Form VS No.62 NEW YORK /-,.` -- -�'"'
STATE DEPARTMENT OF HEALTH
ALBANY
vg' A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each
dead body transported by common carrier.—Rule 1.
z.
PERMIT OF LOCAL REGISTRAR
Dist. No. 9__v. egistered nNo.. 7
Date of issuance AAA,tt _.....cc-���! _IL t9,34
A satisfactory Certificate of Death having been filed and recorded in my office for.... . .A`-11_S�`kbl..l�. Vte.r.VA.5.H
) , who died in the, fil.Y1Y14.'1NtL'u_Y.A_. �!___/40. ..4.19,4 ,
Al ;City, Village or Town) - Q- .• I
a County of �l1A�b.K , State of New York, on. J Y' �M 9 and
.a the hod having been prepared strictly in accordance with RULE "C , as certified by 1.11... • %& ,Yr_{_s
(Name and
7 x.lf a_3_bV!.Ui.k.ka.. Shipping Undertaker, PERMISSION IS H .REBY GRANTED
w address of Shipping Undertaker)
'o FOR THE REMOVAL AND SHIPMENT OF THE BODY OF SAID DECEDENT; Name of tti,.....
^^ ` �b y r'� consignee'.0 licie51 t1'i--s?jj,CeitN• tt ; Point of Saipment,_ a.J0,1RYt_QYV1eYl..,.e . .__-_----_ . Point of
destination &lQHa VIA Ls- NA�� '
(SignatureJD of Locales,,,,.
gistrar) h'\- , .--'__IV.1 - . `
d° Local Registrar of the. _SLKV1ILYVVVI4--� i!1A►\ ---kAC:0__ l_ l- ,Co!:t y of k4.Y Slt ,e ,
City, Village or Town) ,
. State of New York.
ROUTING
The Railroad or other Transportation Agent must enter hereon a description of the ticket held by the passenger in charge
4 of the corpse,the exact route,and VIA WHAT JUNCTIONAL POINTS it reads.
SPECIAL INSTRUCTIONS—A burial case containing a corpse must not be received for transportation unless the person in charge presents a Transit Permit issued
by the Local Registrar of Vital Statistics (Rule I), and an Undertaker's Certificate stating that the body has been prepared for shipment in accordance with
the Laws of the State;nor should it be received even then if any fluids or offensive odors are escaping from the case.
Date r9
From State of New York,to State of
No.of Escort's Ticket Form No. of Escort's Ticket
No.of Corpse Ticket Form No.of Corpse Ticket
Via. To
Via To
Via To
Name of Passenger in charge 016Place of Residence
Signed 1 aping Agent
:
.r,k ;L I
NEW IORK
STATE DEPARTMENT OF HEALTH
ALBANY
SPECIAL ADMINISTRATIVE RULES RELATING TO THE TRANSPORTATION
OF DEAD BODIES BY COMMON CARRIERS
[In effect throughout the State of New York,excel`.in the City of New York,on August I, 1915]
RULE 1. A transit permit and transit label issued by the local registrar of vital statistics must accompany each dead body trans-
ported by a common carrier.
The transit permit shall state the date of issuance, the name, s-x, race and age of the deceased, and the cause and date of death.
The transit permit shall also state the date and route of shipment,jhe point of shipment and destination, the method of preparation
of the body, and shall bear the signature of the undertaker and theisignature and official title of the officer issuing the permit.
The transit label shall state the date of issuance, the name of the deceased, the place and date of death, the name of the escort
or consignee, the point of shipment and destination;and shall bear'-he signature and official title of the officer who issued the transit
permit. The transit label shall be attached to the outer box or case.
RULE 2. The transportation by common carriers of bodies dead of any diseases other than those mentioned in Rule 3 shall be
permitted only under the following conditions:
(a) The coffin or casket shall he encased in a strong out box made of good sound lumber,not less thane of an inch thick.
All joints shall be securely put together and the box tightly 'osed, Either the coffin or casket, or the outer box or case, shall
be watertight.
(b) 'AVh.r, the declination-cannot-be_reaehPd within.6o,, us after death,all body orifices shall be closed with absorbent_
cotton,and the body placed at once in a coffin or casket which ihall be immediately closed anti die coffin or ca.saei:sbai be ( ' -t
in a strong outer box made of good sound lumber not less than$of an inch thick. All joints must be securely put together and
the box tightly closed, and either the coffin or casket, or th< outer box or case, shall be watertight.
RULE 3. The transportation by common carrier of bodies dead of smallpox, plague, Asiatic cholera, typhus fever, diphtheria
(membranous croup, diphtheritic sore throat), scarlet fever (scarletrash, scarlatina), shall be permitted only under the following con-
ditions:
All body orifices shall be closed with absorbent cotton, the body shall be enveloped in a sheet saturraled with a 7 elective
disinfecting fluid and shall be placed at once in a coffin which shall be immediately and permanently closed. The coff; <.:fir casket
shall he encased in a strong outer box made of good sound lumber, not less than s of an inch thick,all jc s of=. ills it shall be
securely put together and the box shall be tightly and permanently closed. Either the coffin or casket,or ou;.er box Cr case,
shall be watertight.
RULE 4. No dead body shall be disinterred for transportation by common carrier without the previous .. jf arth<r dos
having jurisdiction at the place of disinterment. The transit.permit and transit label shall be required as t,. ,;;i :s Rule
Paragraph(a) of Rule 2 shall apply.
RULE 5. Every outside case holding any dead body offered for transportation by common carrier shall bee- at least four handles
and when over 5 feet 6 inches in length,shall bear six handles.