Harris Sr, Charles SOUTH CAROLINA BURIAL — REMOVAL — TRANSIT PERMIT Aiken
STATE BOARD OF HEALTH County
DEPARTMENT OF VITAL RECORDS 07772
Permit No.
Name of Deceased Date of Death (month, day, year)
Charles C. Harris, Sr, November 28, 1973
Name of Address of Funeral Home 211 Pk. , Ave. , S . W. Method of Disposal
a Funeral Home, Inc. 29801 xxxicx� coati xxxxxxixxA moval
George Aiken,S .C. ( )Cremation ( ) Other
Name and Address of Attending Physician, Medical Examiner, or Coroner
Melvin L. Hass, M.D. 1003 Chafes Ave. , Augusta, Ga. 30900
A certificate of death having been filed,or the requirements of the laws of this state Date Issued (month, day, year)
having been complied with,permission is hereby granted to dispose of this body. November 30, 1973
Siaf Igistrar or other authorized individual Address Aiken COunty Health Dept,
' � �� � � Aiken, S .C.
Nand Address of Cemetery or Crematory
Pine View Cemetery, Queensburg, New York.
Date of Disposition Sign ture pf Sexton or,P son in Charge
/ / fff
SBH-676-750M-4-70 / THIS COPY TUBE GIV N TO FUNERAL DIRECTOR