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Van Benthuysen, Marlene COMMONWEALTH OF VIRGINIA BUREAU OF VITAL RECORDS AND HEALTH STATISTICS DEPARTMENT OF HEALTH RICHMOND, VIRGINIA °o OUT-OF-STATE TRANSIT PERMIT c FULL NAME I AGE .y OF DECEASED Marlene Teresa Van Benthuysen 46 c PLACE OF (City or County) DATE OF (Month Day Year) DEATH Alexandria, VIRGINIA DEATH September 23, 1980 q .4 SEX RACE OR in 8 Female I COLOR White w a DESTINATION TO WHICH (City or County) (State) 0 9 REMAINS TO BE SENT St. Al phonsus Cemetery, Glens Falls, New York 8 w - A Certificate of Death having been filed as required by the laws of this State, or conditions outlined in n regulations having been complied with, permission is hereby given to: S Funeral Director Everly-Wheatley Funeral Homes Address Alexandria, Virginia H To transport said deceased as stated above. DATE I REGISTRATION SIGNATURE OF 6-) M ISSUED9/24/80 DISTRICT NO. 20� REGISTRAR © la COMMONWEALTH OF VIRGINIA BUREAU OF VITAL RECORDS AND HEALTH STATISTICS DEPARTMENT OF HEALTH RICHMOND. VIRGINIA oo OUT-OF-STATE TRANSIT PERMIT FULL NAME I AGE 'y OF DECEASED Marlene Teresa Van Benthuysen 46 v PLACE OF (City or County) DATE OF (Month Day Year) DEATH Alexandria, VIRGINIA DEATH September 23, 1980 oOR '. SEX Female COLOR White W c DESTINATION TO WHICH (City or County) (State) oe REMAINS TO BE SENT St. Aiphonsus Cemetery, Glens Falls, New York M a A Certificate of Death having been filed as required by the laws of this State, or conditions outlined in regulations havingbeen complied with, permission is herebygiven to: 9 g P g' ' Funeral X Director Everly-Wheatley Funeral Homes Address Alexandria, Virginia I'L-, To transport said deceased as stated above. i; DATE REGISTRATION SIGNATURE OF t^ ISSUED9/24/80 DISTRICT NO. 20� REGISTRAR o 4 ,a,....,_ 9