Cooke, Walter DEPARTMENT OF HEALTH OF THE CITY OF NEW YOBS
BUREAU OF VITAL RECORDS
M 314 3 B TION—TRANSPORTATION PERMIT
Date Fri3 15 1973
The Certificate of Death having been furnished to this Department, as required by the Health Code, permission is
hereby given to.... t, .�_.....:_ a of_ /Co(-It 3,a ,_._,_ . 'Ng__7 __.w
)11
to remove the remains of ___. ._...._ _ ...Age g... ..._ __Yrs. ___ .Mos. ..Days,
who diedat_.. � !�?�a ,� -�^ _(Lp.,.. Borough of Manhattan,
t{' ? 9City ew York, on__ z. ....L_ , ). _ 19 _.
for Burial*at_.....6 1!._�-120J `��- f Y� a- — on FEB7 197319_.._
U This permit must be banded to the Keeper
of the Cemetery or Crematory by the
Funeral Director in charge of the funeral. If, City Registfar. {
• City Registrar
Cross out one. y.s.
1HH-35M-705500(72) 346
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