Kennedy, Dennis DEPARTMENT OF HEALTH OF THE CITY OF NEW YORK
BUREAU OF VITAL RECORDS
X ..1345-9 - BURIAL—CREMATION—TRANSPORTATION PERMIT
Date
The Certi / of Death having bee tarnished to this Department, as requi by the H alth Code, permission is
hereby given to 1 _.__ /'� r��i_ f
to remove the remains f __ __._._..f1ge r , os. _...._:._.....Days,
who died at_. _._ . /. ~� ugh of ,
City of New York, on _p 1! ,19 4
for Burial*at.... (.441 '! '--1-'- on 7-/ 19 7 7
This permit must be handed the Keeper 1� , t
of the Cemetery or Crematory by the
Funeral Director in charge of the funeral.
ity Registrdr.
LI
•Cross out one. Per._... . ....-_
HH-35M-705500(72) to 346 W