De Marsh, Mary TEXAS DEPARTMENT OF HEALTH BURIAL—TRANSIT PERMIT PERMIT -
BUREAU OF VITAL STATISTICSNUMBER 1111
1. Full name of deceased 2. Date of death(month,day,and year) 3. Death duo to YEs
)a
)ATA ON
MARY DE MARSH April 7, 1980 di No
4.Sex 5.Color or race 6.Age In years 7. Place of death (city or precinct no.) (county) (stole)
DECEASED
Female White 78 Memorial City Hospital - Houston - Harris - Texas
L
Method of Burial Cremation Place of burial (name of cemetery or crematorium) (city or town) (state)
removal or
disposal Removal Disinterment❑ disposal Glens Falls, New York
BANNER AND
Name of funeral director License number Business addressBENTLEY MORTICIAN'S SERVICE CO,
'LACE OF 5243 6325 Beverly Hill - Houston, Texas, 77054
)ISPOSAL JOHN W. BENTLEY
Name of embalmer(if none,write none) License number Business address
JOHN W. BENTLEY 3897 Same
A certificate of death having been filed as required by the laws of Texas and all laws and regulations governing the preparation and
IUTHORIZA- disposal of dead bodies having been complied with, permission is hereby given to dispose of the body as identified above.
rION TO
)ISPOSE OF Signature of local registry'?� District (city or precinct no.) (county) Dote
IODY 4.44 et, Houston Harris 4/7/1980
Body was Date , "f �_ Name o..f frmetery o crematory
)ISPOSITION
Buried Li Vidi 1 yi cm AS 6 G trG'Y")
)F BODY Agation �or town) Ji (county) (state) No f s on or urge
Cremated❑ /WM V/tWI S t•!V iR+ 14'*1 /`r�{ y g
., y" a
READ CAREFULLY
REGISTRAR: A burial-transit permit shall not be issued until a certificate of death or of stillbirth(fetal death)has been
filed as required by the Texas Vital Statistics Law and the regulations of the Texas Department of Health Resources.In
special emergencies, you may, at the expense of the applicant, telephone the State Bureau of Vital Statistics for
instructions.
FUNERAL DIRECTOR: A burial-transit permit is required for any manner of disposition of a dead body, including
interment, storage, cremation, and transportation. A separate cremation permit shall be obtained if required by the
provisions of Section 2,Article 969,Code of Criminal Procedure.A burial-transit permit is required for each stillbirth(if
the period of gestation is 20 weeks or more)before disposal of the body.
When used as a transit permit for transportation by common carrier,the burial-transit permit shall be enclosed in a
strong envelope and attached to the shipping case.No separate transit permit is required.
SEXTON: It is unlawful for any sexton,or other person in charge of a burial place,to permit burial or other disposition
of a dead body before a burial-transit permit is deposited with him. The sexton may accept the permit of any state or
the District of Columbia.