Brumagen, Arthur � t� te of Aetatuare
STATE BOARD OF HEALTH
DOVER, DELAWARE
AUTHORIZATION TO RE-ROUTE DECEDENTS UNDER MILITARY JURISDICTION -,,
Authorization is granted the Dover Air Force Base to re-route
Name Of Decedent BRUT GF. .,-..ART i..Z+• 2VITA....114MC
7110/29 who died 1.1124A6
Age or 8irthdate Date of Death
VIETNAM GLEL.EALLSI..NE4..Y.Calc.
Place of Death Place of Interment or Receiving Cemetery
12/5/66 /
Date Issued Authorized Signature of Deputy Registar
SN L24.2 This Permit is to be retained by the Sexton of the Receiving Cemetery, if no Sexton the Receiving Funeral Director
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