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Bigelow, John 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 CERTI- FICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. 17 Registered No. Town, Village Dist. No. 198 County Albany or City Albany New York If city, give street address) Name of deceased _John_-B--Bigelow Veteran WW-2 (If veteran, give name of War) Male Single, married,widowed, Married 1/10�79 Sex or divorced (write the word) Date of Death 19 Age 55 Years Months Days Birthplace Vermont Cause of Death Cerebral edema Certificate was signed by L. Satler M.D. Address VAMC Albany New York Place of Burial (or Removal) Glens Falls, New York (If body is to be temporarily held, fill in space later) 1/13 79 Cemetery Pine View Cemetery Date of Burial 19 (If body is to be temporarily held, fill in space later) The CERTIFICATE OF DEATH containing the above stated particulars, having been presented to me, after careful examination, 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 HERE- BY GRANT A PERMIT to Rich Funeral Home Ridge St. ,Glens Falls, New York (Name) (Address) the Undertaker to hold temporarily and I�t the body (UnlertakEr ,p pp having charge of corpse) (Intel. o� o . wise ispose (scat )) Dated 19 (Signed) ,' _. al egistrar This Permit is sufficient for the Removal (and Interment or Cremation)"a body t;�any part of the State (subject to local cemetery or other regulations), unless removal is by common carrier, in whic ase a Tra sit Permit (VS No. 62) is required. FORM VS.61.(REV.6/63)(7A4-53) ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE D = \ �� / 19 ' '>)Date of was — / (Interment or r' . (Name of Cemetery, o umm,, etc Section c / Lot No. " ' s Grave No. / (Signed) l i' - (Person in Charge) Address 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 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 the Registrar of District in which cemetery is located. SEXTONS, FUNERAL DIRECTORS and UNDER- TAKERS violating the law relative to the return of permits are liable to a penalty of NOT LESS THAN FIVE DOL- LARS NOR MORE THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The law will be enforced. Local Regis- trars are required, under penalty, to report violations thereof.