Labourr, James $fat of ! taIure
STATE BOARD OF HEALTH
Dover, Delaware
AUTHORIZATION TO RE-ROUTE DECEDENTS UNDER MILITARY JURISDICTION
Decedent's Name LABODRR, JAMES ROGER. / Birthdate or Age 1 JAN 1957
BARCELONA HARBOR 17 JAN 1977
Place of Death_ � SWAIN• Date Expired
The Dover Air Force Base is authorized to transport the above named decedent to
HUDSON FALLS NEW YORK / CARLEFON FUND AL HOME '
Destination-Town State cf..4„,...„Rx Name of Receiving Funeral Director g.e/p
•
eiving Ceme y o Place of I
22 JAN 1977 ' 7j /:' - 'C- J - ,/
Date Issued Signature of Deputy Registrar
SW L24-2 This Permit is to be retained by the Sexton of the Receivinu. Ce»aelery, if no Sexton the Receiving Funeral 1)ireclor