Bigelow, Gilson iiiCvv .vRn .7IMIC YCrnR1mCIII Vr fCALIn
OFFICIAL BURIAL (OR REMOVAL) PERMIT
IIF This permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Primary Registration District
(Town, Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTI-
FICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Registered No. ___1.7
5755 Washington Town
Dist. No. County of y Fort Edward
If city, give street address)
Name of deceased Gilson F. Bigelow Veteran no
(If veteran, give name of War)
male Single, married,widowed, separated Sept. 16, 76
Sex or divorced (write the word) Date of Death 19
Age 71 Years Months Days Birthplace Ticonderoga, N.Y.
Cause of Death eLr�u ,,,
Certificate was signed by .Nliltnn_. .._.Greenher$,__Caroner M.D.
Address 32__Pearl__Street_...Hudson Falls., N.Y. 12839
Place of Burial (or Removal) Que_eni3.h_ury, N.Y.
(If body is to be temporarily held, fill in space later) lg 1 6
Cemetery Friends Cemetery Date of Burial Sept. , 97 19
(If body is to be temporarily held, fill in space later)
The CERTIFICATE OF DEATH containing the above stated particulars, having been presented to me, after careful examination,
the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same
for registration, have recorded it in my Local Record with the above stated Registered Number, and on the basis thereof I HERE-
BY GRANT A PERMIT
to M.B.Ki1mer Funeral Home 82 Broadway Ft.Edward, N.Y.
(Name) (Address)
the undertaker to hold temporarily and inter the body
(Unlertaker p rson having charge of corpse) ter, removg, or oth wise dispose,of (state how))
Dated /27 19 t (Signed) (41-2,-1--/-e-t-:..
Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local
cemetery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
FORM VS. 61. (REV. 6/63) (4A2-179)
ENDORSEMENT OF SEXTON OR PERSON IN
CHARGE OF PREMISES ON WHICH INTERMENTS
OR CREMATIONS ARE MADE
Date of ii411444124111 was I ) 19 7,
(Interment or Cre4tivdeA-
)
(Name of Cemeter Crematorium, etc.)
Section )'1, - Lot No. Grave No.
(Signed) 47/10
z;4 (PersoniA� r
Address
Person in charge must return this Permit to the Registrar
of his District within SEVEN (7) DAYS from above date.
If no person is in charge, the FUNERAL DIRECTOR or
UNDERTAKER MUST SIGN ABOVE STATEMENT,
write across the face of the Permit the words "No person in
charge," and FILE PERMIT WITHIN THREE (3) DAYS
with the Registrar of District'in which cemetery is located.
SEXTONS, FUNERAL DIRECTORS and UNDER-
TAKERS violating the law relative to the return of permits
are liable to a penalty of NOT LESS THAN FIVE DOL-
LARS NOR MORE THAN FIFTY DOLLARS FOR THE
FIRST OFFENSE. The law will be enforced. Local Regis-
trars are required, under penalty, to report violations thereof.