Jenkins, Blanche FLORIDA STATE BOARD OF HEALTHI
Bureau of Vital Statistics Pit No,----_.••.•.14-147
PERMIT FOR DISINTERMENT, TRANSPORTATION, AND REINTERMENT
Name of deceased Jul E, ,o.he Griffin Jenkins
Age 91 Race White Sex Female Date of Death March 11, 1258
Place of original burial Receiving Vault Ft. Lauderdale, Florida
(Cemetery) (Address)
Place of reinterment Bay Road. Cemetery Glen Falls, N.Y.
(Cemetery) '?'Address)
Funeral director disinterring ---Phil__FLj-airchild 399
(Name) (License No.)
Permission is hereby granted to disinter, transport, and reinter the body desc 'bed above bject to the regulations on the reverse
side of this form.
Date Permit Issued 4-21-58 S gned:d Qta<4 J - Registrar
Reg. Dist. No. 1 6 Address Broward County, Ft. Lauderdale, Flor da
Endorsement of agent of cemetery from which remains are to be disinterred:
Date
Cemetery Agent
End ,, f-.c oeytery in which remains were reint
; da--€44;.v.- lit/.
1 � emetery Agentaz-Ze
Thi, permit must be surrendered by the fun al director to the cemetery where reinterment is made. THE AGENT OF THE
C' IETERY (OR THE FUNERAL DIRECTOR IF THERE IS NO AGENT) MUST FORWARD THIS PERMIT WITHIN 10
DAYS TO THE L L REGISTRAR OF HIS DISTRICT. C-� Q� 0�i' L''
IL-
FORM V.S. NO. 246y l "� (Over)J
k
INSTRUCTIONS - READ CAREFULLY
This PERMIT does not by itself entitle the holder thereof to the right to disinter the body. Permis-
sion to do so must be obtained from the next of kin of the deceased or the proper legal authority. In
cases where an autopsy is to be performed, permission must be obtained from the next of kin or other
proper legal authority.
The purpose of this permit is to certify that the Local Registrar has been notified of the intention to
disinter and to provide authority for reinterment of the body.
This permit is authorization for transportation of the body by common carrier or otherwise. No addi-
tional permit is required for this purpose.
When a second funeral director is to reinter the body, his name should be added to the front side of
the permit below the name of the funeral director who disinterred.