Bacas, Virginia DEPARTMENT OF HEALTH OF THE CITY OF NEW PORK Form VR-2�(Rev.>is2�s�2M sets
1212t)47(41
(413 B U OF VITAL RECORDS o
tit 06 U L—CREMATION—TRANSPORTATION PERM#'. r
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` - The Cerlificate of Death having bee furnished to this Department, as required by the Health Code, on is
hereby given to I�' Meg r AI beep
X_ P, , A(of... 3 I. 0 v N 7-<nl i� rf/s y.
to remove the remains of. V I le / 4 r4 ,l C-i-' Age.".J.. Yrs Mos- Days,
who died at �sT Oc5P C Borough of tSea LIY
City of New York; one' U/14 02' '= , 19 g.tr4 Certified by '..S C.,ff 1a 1TE/ M.D.
for Burial* at f /� Ir r c--(-J A4# . l�Rl-s i2rey. y. •/UC, ,.Q j f !(
This permit must be handed to the keeper - �_
of the Cemetery or Crematory by the �, City Registrar
dimah
Funeral Director in charge of the funeral
'Cross out one. ,.
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