Kantrowitz, Sally FORM VS NO. 62 Attach part below to outer box or case 2-70-10M(B3-3)
TRANSIT LABEL
NEW YORK
STATE DEPARTMENT OF HEALTH
ALBANY
A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead
body transported by a common carrier. — San. Code Sec. 13.1 (a).
2700 PERMIT OF LOCAL REGISTRAR
DIST. NO. Registered No.
Date of issuance 10' _7A 19
Ka
A satisfactory Certificate of Death having been filed and recorded in my office for Sally H. Tlt? ^.AIi fZ
who died in the C tv of Rochester
. Monroe (City, r own
Y County of ,State of New York on Oct. 2, 19 7 , and
u
a
▪ the body havin been prepared strictly ,� c rdt e w San. Code Sec. 3.1, Par.A-2. ..�.. ,., as certified by
• Parsky Plneral HCMe i.,z 5 with . t . Aoche ter, .', .Y
n Shipping Funeral Director/Undertaker, PERMISSION IS HEREBY
°• (Name and Address of Shipping Funeral Director/Undertaker)
-o GRANTED FOR THE REMOVAL AND SHIPMENT OF THE BODY OF SAID DECEDENT; Name of escort or consignee '
▪ S} 11vap & Min h.n Inc . ; Point of shipment. 3ocheFte1 , N. Y.. ,Vlens-rails, .- .
>. Point of destination haarav„rpfi.i.a.. Cem...Q7, e .Falls, r'S.y
... _
• • • • •••a• ..
a' (Signature of Local Registrar) i
a Local Registrar of the V of ROCreSt' r , County of Mohr e ,
State of New York. (City,
ROUTING
The Railroad or other Transportation Agent must enter hereon a description of the tickets held bythe
Q P 9 P passenger in charge
of the corpse, the exact route, and VIA WHAT JUNCTIONAL POINT,it reads.
SPECIAL INSTRUCTIONS—A burial case containing a corpse must not be received for transportation unless the Person in charge pre-
!� sents a Transit Permit issued by the Local Registrar of Vital Statistics, and a Funeral Director's or an Undertakers Certificate stating
that the body has been prepared for shipment in accordance with the Laws of the State, nor should it be received even then if any fluids
or offensive odors are escaping from the case.
Date 19
From State of New York to. State of
No. of Escort's Ticket Form No. of Escort's Ticket
No. of Corpse Ticket Form No. of Corpse Ticket
Via To
Via To
Via To
Name of Passenger in charge Place of Residence
Signed Shipping Agent.
NO,"
STATE SANITARY CODE
PART 13
TRANSPORTATION OF DEAD BODIES
(Statutory authority: Public Health Law, § 225)
Sec.
13.1 "Transportation of dead bodies by
common carrier
Section 13.1 Transportation of dead bodies by common carrier. The transportation of dead human bodies by common car-
rier shall be conducted in such manner as not to be a menace to health and shall conform to the following requirements:
(a) Transit permit and label required. A transit permit and label issued by the local registrar of vital statistics must ac-
company each dead body transported by a common carrier.
(1) The transit permit shall state the date of issuance, the name, sex, race and age of the deceased, and the cause
and date of death. The transit permit shall also state the date and route of shipment, the point of shipment and destina-
tion, the method of preparation of the body, and shall bear the signature of the undertaker, and the signature and official
title of the officer issuing the permit.
(2) The transit label shall state the date of issuance, the name of the deceased, the place and date of death, the
name of the escort or consignee, the point of shipment and destination, and shall bear the signature and official title of
the officer who issued the transit permit. The transit label shall be attached to the outer box or case.
(b) Transportation of bodies dead of other than enumerated diseases. The transportation by common carrier of bodies dead
of any diseases other than those mentioned in subdivision (c) below shall be permitted only under the following conditions:
(1) The body shall be encased in a sealed metal transfer shipping case or in a coffin or casket.The coffin or casket
shall be encased in a strong outer box made of good sound lumber, not less than seven eighths of an inch thick, and all
joints shall be securely put together and the box tightly closed. Either the coffin or casket, or the outer box or case,
shall he watertight. When shipment is made by air, the coffin or casket may be encased in a sturdy plywood outer box or
receptacle made of heavy water-repellent canvas or equivalent material,designed specifically for the purpose. Every out-
side case holding any dead body offered for transportation by common carrier shall bear at least four handles and when
over five feet six inches in length shall bear six handles.
(2) When the destination cannot be reached within 60 hours after death, all body orifices shall be closed with absor-
bent cotton and the body placed at once in a coffin or casket which shall be immediately closed and the coffin or casket
shall be prepared as indicated in paragraph (1) of this subdivision.
(c) Restrictions on transportation of bodies dead of enumerated diseases.The transportation by common carrier of bodies
dead of smallpox, plague, Asiatic cholera, typhus fever, diphtheria (membranous croup, diptheritic sore throat), scarlet fever
(scarlet rash, scarlatina), shall be permitted only under the following conditions: all body orifices shall be closed with abso-
rbent cotton, the body shall be enveloped in a sheet saturated with an effective disinfecting fluid and shall be placed at onc
in a coffin which shall be immediately and permanently closed. The coffin or casket shall be prepared as indicated in para-
graph (1) of subdivision (b) of this section.
(d) Restrictions on disinterment. (1) No dead bodies shall be disinterred for transportation by common carrier, or for re-
moval to another cemetery in the same registration district, or in another district, but not requiring shipment by common
carrier, without the previous consent of authorities having jurisdiction at the place of disinterment.
(2) The undertaker shall make a request to disinter the body on a form provided for the purpose. This form shall pro-
vide for a statement of principal facts concerning the decedent, whether body is to be transported by common carrier or
otherwise and final disposition of same. Upon receipt of such request the local registrar shall issue a transit permit and
transit label as required by subdivision (a) and the provisions of paragraph (1) of subdivision (b) shall apply.
(e) Exceptions. Notwithstanding any other provisions of this section, dead human bodies, prepared for shipment by the
War Department of the United States in accordance with the repatriation program, may be accepted by common carriers for
shipment to places designated by that department. Under the authority of a basic health permit issued by the War Department
the registrar of vital statistics of the district to which such a dead human body has been transported shall issue a permit for
the burial, removal or other disposition of the dead body. The permit shall be made out as completely as possible on the basis
of the information available.
FORM VS NO. 62 2-70.10M(B3-31
TRANSIT PERMIT
NEW YORK
STATE DEPARTMENT OF HEALTH
ALBANY
!AV.. A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead
body transported by a common carrier. — San. Code Sec. 13.1 (a).
CERTIFICATE OF FUNERAL DIRECTOR OR UNDERTAKER
I Hereby Certify that the accompanying dead body of Sally R. Kantrow tz
Veteran' no who died in the ''1ty of Rochester
(If veteran,give name of War) (City, `4 e..aa.I wn) +
r �wg1e
County of ly+ol!3� Oe , State of New York, on Oct " ? • 19 .7.R..,Sex.f.ePIa�.p WidMowed
Divorced
Color or race White Age 7o years months days. Birthplace N.Y. and Cause of
cardiac arrest
v_ IDeath_-.-. . --- .-_-._...--._.-.....-�-z_. --«._-- T,c_.-- ----r.: - <,.- --- -___-has-been prepared-for transper:ation
strictly in accordance with San. Code Sec. 13.1, Par... A-2 . as printed with thi blank. Certificate was signed by
a Dr. aandi 225�j 5 Portland Ave. Aoch . . N.Y.
c Bri M.D., Address Date of shipment..1.Qr.3..
-a 19 78 ; Route of shipment Allep'hany Airlines ; Point of
3 shipment Rochester, N.Y. ; Point of destination Shaaray Tefila Ce"' . Glens Falls , N.Y.
T Sullivan & Minhan Inc. Glens Falls, N.Y.
Name and Address of Consignee �y / ,/
tTp
°� (Signature of Funeral Director/thnlertaf«,), (.€ '4 / �¢ t Reg. No. .a � ' /
Dated �v� 19. ./a
Address /! Z'? ...� .( �'d 7� 1: :
`; *Cross out words not applying.
T PERMIT OF LOCAL REGISTRAR
0
DIST. NO. 2700 Registered No.
a Date of issuance 20-3-78 , 19
i A satisfactory Certificate of Death for above decedent having been fi a d recorded in my office. PERMISSION IS
HEREBY GRANTED FOR THE REMOVAL AND SHIPMENT OF THE BOD .
(Signature of Local Registrar) , .. . .
City Rochester Monroe
Local Registrar of the of , County of. .. ,
(City,Viiiagel-Pflwrr�
State of New York.
Only the Local Registrar (Deputy or Subregistrar) may issue a Burial, Removal or Transit Permit
Or Detach here and give part above to escort or attach to waybill if shipped by express.
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON
WHICH INTERMENTS OR CREMATIONS ARE MADE
Date of was 19
(Interment or Cremation)
(Name of Cemetery, Crematorium, etc.)
Section Lot No Grave No
Signature
(Person in Charge) (Address)
Persons in charge must return this Permit to 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 STATEMENT, write across the face of
the Permit the words "No person in charge" and FILE PERMIT WITHIN THREE (3) DAYS with 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 NOR MORE THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The
law will be enforced. Local Registrars are required, under penalty, to report violations thereof.