Gilchrist, Thomas .?orn3 vs.el. NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tr This Permit can be signed only by the Local Registrar (Deputy or subregistra.r) of the Primary Registration District (Town,
Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Town Registered No-
5907 Westchester Village
Dist. No County or City Yonkers$New York
(If city, give street address)
THONAS BYRON GILCHRIST
Name of deceased Veteran
(If veteran. give name of War)
Single, married, widowed,
male widowed
Sex Colorwhite or divorced (wnte the word) Date of Death Jan, 214
.Months „- .Days -Birthplace Southl-artpx;(1., y .
Age 7° Years .Monthsarterioscierotac carg.io vancrlpr disease
Cause of Death
Certificate was signed by Frederic Knilham M.D.
Address Bronx IlewYork...Gityliliew ;Dirk
N
Place of Burial (or Removal) ilen Falls,. ew York
(If body 1g to b$temporaylly held,All in space later)
Cemetery ine View Cemetery Date of Burial Jan.. .2.7.th 19 62
(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 exami-
nation, 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 oil the basis thereof I HEREBY GRANT A PERMIT Bronxville 3New York
Fred 1-1.1vicGrath ez bon
to
F. D. (Name) Inter (Address)
the to hold temporarily a,id the body.
(131?Viaokewernson having charge ofAo5pse) ter eldeear:5erwl is se state bow])
Dated 19 u (Signed) ' 1
Local R
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the (subject to local
cemetery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
ENDORSEMENT OF SI X'UN OR PERSON IN CHARGE OF
PREMISES ON WHICH INTERMENTS OR CITATIONS
ARE MADE
Date € t w 19
(Interment o1 re`n)
77.
i
(Name of Cemetery, Crematorium, a .)
2 //7 4.
Section . — Lot No. Grave No.
//
(Signed)/.. l� ; 1 > ( (('
(Person in charge)
Address / C J 10 cL � ,
/
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 STATE
MENT, 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 UNDERTAKERS
violating the law relative to the return of permits
are liable to a penalty of NOT LESS THAN FIVE DOLLARS
NORWMORE THAN FIFTY DOLLARS FOR THE FIRST OFFENSE.
The law will be enforced. Local Registrars are re—
quired, under penalty, to report violations thereof.