Dutson, Edwin 1.1/
d
� place °f death deceased..... BURIAL-Tv
STATE BOARD
•o Date of death......
ANSIT PE oriel permit No.O� A TH i
If
Method deathi(Cicyet/ R.MjTS
ce
d of disposal /_� f
2.
c my cwhe
then burls], ,f Color..... .....cOuhtyl
F `9 ert' • cre�atloiY' ...-... 1� ' k
to--•--•- icate of deaf ••-...-..-. _ transport$tioII;•s....... -• Sex.. ' -....Florida....
f to (Funer$1 Navin b e St tor$$..etc...................
................. ge...-
dispose of body -r vets-- n filed as re ate...-.............. ...
-...� (°effete- '• --� � ..........
to, Dad is dy °f said °n act/n -. required b or - � ..... <:
sued-... d eCeased as abouch.........
•... License Noy the l�s of this-State .- °rem$tOrri C.
Bo CE -... ,/ ��6°e stated• , Aellnissio
F dy was.- A OR CR Signatur hereb
RY n is
l Place- (state bet on� EMATORY A .. n
Whether
y ive .�
�, jr1
K' 1�� P cre�ate� b14'l•1+..t �+' HORjTY $$A�
S•asao .FjQj d.storee C.�• 19. _ FILL (Resrari..
•
A' in_........CF-AyTF�gL OUT ��
turned permit AC '`
rye wlthinrnit must -.. signature.
i � FhaRID,q C E B�� w •... ........ ....A .
1p days to th endorsed y the gnature., (oeete 7'U
b ° ore t RY «
Registr Sexton or (8exto 'off' ' ..-
r °f the district by the
thel Director person in °barge
b w 4�-..--.-
urial takes piacthere is no
sexton) and
/ qc 7
-a-.� f
s. j �� _ ���"Y ��,•°`° Ida to ����_
AR, gection8 body in-
to-cluding READ ��!� ce with r a dead disposal
U"� in accordance
o`"'dan disposition•rth before
�=i. be issued�ti1y manner for each stillbirth,r i: >" transit Permit may is required for any
requited be enclosed
��s� t:g RAR his burial- ermit A P m
!/" burial-transit
Must FLEGIST TORS ThTebnatio tram tTansPortation ed; °r it that is not Practicable burial other
EUNERALtD e t storage c e body must be embalm burial practicable
sexton may e accept to
cludmgbody. of a.
of the ipment unlawful
k ful outer case.
or other person
er o permit s deposited
n°for burial.)th m. ten days to the registrar
gnfartightlY sealed any sexton,. or Pauthor�za within
as forwarded awful for eistr a Columbia' register, d fo body• DO
It is unl d body b an ies each
the District of our sexton's out to attache
XTpN a dead it accompanies r hip-
SE disposition °f state or of in Y sit Pee case; F24 hours after disP of any recorded burial-transit permit Must be endorsed, completed b escaping Win within
All pert-nitsacc a Be sure that a offensive odors3a�ksonville 1,
district. offensive
d of1Kealth,
for Your TIpN AGEN meT,t if gate Boar
�ANSPpgT podY for he Florida S
not accePta mail it to each offense'
coupon of boil up to �5�� for
ment
pENp,L'tY for violations is