Fisher, Zera NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
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 CER-
TIFICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Town, Village Registered No. 258
Dist. No_ ._198 County...Albany or City 113 Holland Ave Albany, NY
(If city, give street address)
Name of deceased Zera Fisher Veteran WW-1
(If veteran, give name of War)
Male Single, married, widowed, Single 6/18/65 19
Sex or divorced (write the word) Date ofDeath
Age 73 Years Months Days Birthplace kleX..XQrlc
Cause of-Death Qcclu§loi, multiple mesenteric arteries
Certificate was signed by Claxa..F...._S.tam 1>l+on M.D.
Address VA Hospital Albany, New York
Place of Burial (or Removal).... Town of Queensbury NY
(If bodye is to be temporarily fiGlenser ails Cemetery6-21-65
Cemetery West (' j�' Date of Burial 19
(If body is to he 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 on the basis thereof I HEREBY GRANT A PERMIT
to Re&an and Denny Funeral Svc Inc 341 Glen St Glens Falls NY
Undertaker (Name) Inter (Address)
the to hold temporari an j the body
(Undertake or e n having charge of c oseL (Inter, ove, or her is 'spose of k`:te • '
q 0il •.
Dated ` ! 19 ��... (Signed) ''-
Local Registr r
This Permit is sufficient for the Removal (and Interment or Cre ation) 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. (Roy, 6/63) (3A2-323)
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE
OF PREMISES ON WHICH INTERMENTS QR
CREMATIONS ARE MADE
Date of was _ 19_
(Interment oy remation)
r
.;,,. .2,e,
..,e>_-✓+� ame of Cem y. Ctrmeloriuiln,-et,.) rc
Section____.__ —_ Lot No. Grave No.____
(Signed) -) II V7?------'
(Person in CtfdPFe)
Address / v e -L•1e'L
1
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 UNDER-
TAKER 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 Dis-
trict in which cemetery is located.
l�
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 NOR MORE
THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The law
will be enforced. Local Registrars are required, under penalty,
to report violations thereof.