Macero, Dan BURIAL---REMOVAL---TRANSIT
URjAL--RE' ]t? V 1� A x11 name of deceased.. - D- 1►'j® " A�(RK F
_ coo NSIT PERMIT
� Place of
W death.._...._.._.__Ti G+2
(City or Town)
Death
Date of Death.._.. �t'r
gamin bl
Method ofn e'
04 disposal TRANSPORTATION--
--....-__. (County)-......_._.-......._ ..._....._G 1;_Gu °diseases__
or Noj.
Z (Whether
,., burial, ��.��T�*� -._ Color__ (State) ----.-
County.-- cremation, f�F-_._ -.._-.....Sex...._.... s
tranapor tion, stora ,
_ (Mili i
_ ge, etc.) _ Ag A certificate of ---___----_... '��-• �'. �T-• _
Di t.
to..- death having been Sled .._. _...__State.__ � �n(Ce>R1�����, vyr
z <� + _.. as required byif hj5 State,
_ o �,yr�� t y -
ry r +e 'or
if ih al the laws of this . .__--n_--^
T� Dire T J
(Add..._js' ----- _..._.-- n is h....
ress) � ...... y given
p Date......... Signed.. '...tq se of e body (License Number)...
_._....- ? L --L. of said deceased
as aboPe
It Body was t IETERy OR E (City or Town '-- -.._._L.
:... Q MATORY LITHO o and RFD) } R.
]t
(State whether on _ TY SHALL ILL IN `_-
locat
[Fr ed at f,� cremated buried,stored SPAC B ty)
, ed„etc.)-... r _. pia.SE 4
WThis permit ®�'HEP SIDE ._..,-..__.... A... (Cemet ._ w;__;
E m See list Permaneily retainedtinthe dorsed by the Se Sjgned_.. mot/ reatory)s
on other side. eon's Sles, xt°n (or the e
IGEoRGjAFuneral D or wfiere there is noarge) -�
ENT UELIC sexton) and
Division of Vital Statistics HEALTH
READ CAREFULLY
Please become familiar with the rules for the transportation of the dead.
REGISTRAR:This burial-removal-transit permit may be issued only upon receipt of a death certificate;
not before.
FUNERAL DIRECTORS: The burial-removal-transit permit is required for any manner of disposition
of a dead body including interment, disinterment, 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 duplicate thereof
should be enclosed in a strong envelope attached to the shipping case. No separte transit permit is required.
Before shipment by train or express, the body must be embalmed; or if that is not practicable must be
enclosed in a tightly sealed outer case.
SEXTON: It is unlawful for any sexton, or other person in charge of a burial place, to permit burial
or other disposition 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 and retained permanently in your files.
PENALTY for violations is provided by laws of Georgia.
QUARANTINABLE DISEASES are smallpox, plague, Asiatic cholera, yellow lever, typhus fever,
diphtheria (membranous croup or diphtheretic sore throat), scarlet fever (scarlet rash or scarlatina),
erysipelas, anthrax and leprosy.