Schwartz, Roy DEPARTMENT OF HEALTH OF THE CITY OF NEW YORK
X 1783 BUREAU OF RECORDS AND STATISTICS
BURIAL—CREMATION—TRANSPORTATION PERMIT
FEB 1 0 1970
Date.
The Certificate Depth having been furnished to this Department, as required by the Health Code, permission is
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hereby given to-___I__.Z: - 44: - ...Z_ -- ----__of. -, 7
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to remove the remains of ‹,..'4- Age Z.Lta..Yrs.........-...blos. -.Days,
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who died at...1.3.....f 6 ,/t, - . .e" (---- c-,,,--,--).-<— -,----7 pli
Borough of
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City of New Y ork, o .. -.........1............S.." . ?............i
ermnzatrint-- IL _ 19
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fort{d."1.-41, ...i." t 4--
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on...L.-I.:Lt.- 1 .
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This permit moat be.hatted trythe Keeper " /61 --aft-N--7.7 71
—..— .0.. (6AllinjYte4sZ
iunerh:1 Diret;or in Charge of the funeral. , or A.Rogisgrof _
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•Cross out one. pe,! 1-1-- '
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