Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
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