Gray, Emmet Always write with black ink.
CONNECTICUT STATE DEPARTMENT OF HEALTH
Hartford, Connecticut, U. S. A.
REMOVAL, TRANSIT AND BURIAL PERMIT
(This permit is sufficient for removal of a body to any town and also for interment)
No.of permit
Date July 29, 1951
The certificates required by the state statutes have been received and recorded,that the body has been prepared in accordance with the Sanitary Code. Permission is
granted to remove the body of
If veteran
Emmet LeRoy Gray name war
who died at State Hosps ' TQ �I. CONN., July 28, 1951
Age 73 years months days. Sex Male Race or Color White
Cause of death Arteriosclerotic Heart Disease
for Burial in Pine View Cemetery in Glenne Falls N.Y.
(Name of Cemetery) (Town) (State)
Fun. Dir.
Issued to Clark Funeral Hone or Address Glenns Falls N.Y.
Embalmer
'Embalmer's License No.1G48
THIS IS NOT A CREMATION PERMIT egistrar of ital Statistics
Town of MIDDLETOWN, CONN.
NOTICE
1. No body may be buried without a permit from the registrar of the town
in which the person died.
2. The permit accompanies the body. If transportation is by common carrier,
a transit paster (OVS 10) must also be attached to the box.
3. This burial permit must be given to the person in charge of the cemetery.
The sexton of the cemetery is required to endorse this permit with the date and place
of interment and forward it to the registrar of the town in which the cemetery is
located.
4. A temporary permit (OVS.26) is good for only 24 hours.
b. If the body is to be cremated,a cremation permit (OVS 48) must be obtained
in addition to this permit.
SEXTON'S ENDORSEMENT
Th.'r,d /•f✓''hh this permit was issued +was buried
cemetery o 44.. .f 19 .
Sexton