Duclos, Gertrude JIAIG LiGr/iRIIYI GPI I Jr rI UAL.In
M o Bureau of Vital Statistics
I P Richmond, Virginia
BURIAL—REMOVAL--TRANSIT PERMIT
Q Full nave of deceased firs . Gertrude L. DUclos
O
AE. Place of death Municipal Hospital Norfolk , Virginia
-I Date of Death F elf t)ary 11 i9 58 Colorv('� to Sex Female Age) 75
dj2 w Method of disposal Transportation Cemetery St. plphonsus
i+i P4 (Whether burial, cremation, transportation, storage, etc.) (Cemetery or Crematory)
4 z City R r Glenfal is State New York
County
A certificate of death having been filed as required by the laws of this State,permission is hereby given
Q o to _ H. D. Oliver Address 1501 Colonial Ave. Norfolk Va.
(Funeral Director or person acting as such)
w .4 to dispose of body of said deceased as above stated.
ITorlol. r Va. this._,,,_ 11 Februar 58
(� � Dated at day o� y _19_
' ( s 's address) l 14 , ('
F Registration District No. � � Signature 1'..(- * !'L
�' (Registrar)
CEMETERY OR CREMATORY AUTHORITY S ALL FILL OU ACE BELOW t'
a �(
ti cn Body was_ stt�red. etc.) emeter ...minatory)on 19 > V __ in__g I-.
vi (State whether cremated, buried, red.
t+ Place ____ 'C__ n n Signature
Rtje
:(iCJr��+ 1 (Sexton or person in charge)
/ • 1
READ CAREFULLY
REGISTRAR: This burial-removal-transit permit may be issued only upon receipt of a death certificate, not before.
In special emergencies you may telephone the State Registrar of Vital Statistics, at the expense of the applicant, for in-
structions.
FUNERAL DIRECTORS: The burial-removal-transit permit is required for any manner of disposition of a dead body,
including interment, storage, cremation, and transportation. A permit is required for each stillbirth before disposal of the
body.
When used as a transit permit for transportation by common carrier, this permit or a duplicate the-eof should be en-
closed in a strong envelope attached to the shipping case. No separate transit permit is required.
Before shipment by train or express, the body must be embalmed; or if that is not practicable it must be enclosed in a
tightly sealed casket or outer case.
SEXTON: It is unlawful for any sexton, or other person in charge of a burial place, to permit burial or other dis-
position of a dead body before a burial-removal-transit permit is deposited with him. (The sexton may accept the permit
of any state or of the District of Columbia as authorization for burial.)
All permits must be endorsed, recorded in your sexton's register, and forwarded within ten days to the registrar for
your district.
PENALTY for violations is from $5 to $100 for each offense.