Mattison, Arthur Always write with black ink.
CONNECTICUT STATE DEPARTMENT OF HEALTH
Hartford, Connecticut, U. S. A.
REMOVAL, TRANSIT AND BURIAL PERMIT
(This permit is sufficient for removal of a body to any town and also for interment)
No.of permit
Date JAN. 10, 1975
The certificates required by the state statutes have been received and recorded, that the body has been prepared in accordance with the Public Health Code.
Permission is granted to remove the body of
If vet
ARTHUR CARROLL MATTISON name war WW 11
who died at VETERANS ADM, HOSPITAL, WEST HAVEN, CONN. on 1/9/75
-- Date of Birth Age(in years If under 1 year If under 1 day
last birthday) Months Days Hours Mins.
9/28/99 75 MALE WHITE
Sex _Race or Color
Cause of death RESPIRATORY FAILURE MYOCARDIAL INFARCTION & CARCINIMA LEFT LUNG-
for Burial in PINE VIEW CEMETERY Cemetery in GLEN FA T.T S y N.Y.
(Name of Cemetery) (Town) (State)
EDWARD LAWRENCE FUN. HOME Fun. Dir. Address 2119 POST RD.t DARIEN, CONN.
Issued to orEmbalmer Embalmer's License No. 1929
Registrar of Vital Statistics •
THIS IS NOVA CREMATION PERMIT
Town of WEST HAVEN