Lambert, Margaret DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
VITAL STATISTICS
APPLICATION FOR BURIAL-TRANSIT PERMIT
NAME OF First Middle Last DATE Month Day Year
ECEASED OF
((Type or print) MARGARET MORRELL LAMBERT DEATH Feb. 19, 1980
PLACE OF DEATH CITY, TOWN, OR LOCATION NAME OF (If not in hospital, give street address)
COUNTY HOSPITAL OR Volusia Daytona Beach INSTITUTION Halifax Hospital
Attending Physician [ (Name of Medical Certifier) (Address)
Medical Examiners ❑ Dr. James A. Carratt, 1243 S. Ridgewood Ave. , Daytona Bch,F1 ,
Funeral (Name) (Address)
Home Baggett & Summers, Inc. , 736 S. Beach St. , Daytona Beach, Fl.
Check A ❑ A completed certificate of death accompanies this application.
One
Carratt Feb. 20, 80
B DC Dr. was contacted on ,19
He has assured me that this death was from natural causes and that he will complete and sign the medical
certification of cause of death.
C ❑ The attending physician was unavailable or this death comes within the Medical Examiners jurisdiction.
The body was releases o me by
on ,19
rP/3 2 -. c-dP0
(Signature) (Fla. Lic. No.) (Date Signed)
Funeral /
Director
BURIAL TRANSIT PERMIT Permit 1689-1373
N o.
Permission is hereby granted to dispose of this body by burial, transportation out of state, storage or cremation. For cremation a
waiting period of 48 hours after death must be observed and the Medical Examiner's approval must also be obtained.
kA five day extension of time for filing the death certificate has been requested and granted.
Signature of � Date
Registrar ICJ U..14 t Issued Feb. 20, 1980
CEMETERY OR CREMATORY
Method of Disposition Date of ia,.(p )�6
IllBURIAL Dispositionl/
❑ CREMATION ... c-6e�' � � C°0-zw
[STORAGE ^ Place of r
❑ OTHER(Specify) Disposition ��-��
t. /
Y
Signature of Sexton Gc
or Person in Charge
This permit must be endorsed by the sexton or person in charge (or by the funeral director when there is no sexton) and returned
within 10 days to the local county health department.
HRS Form 326 (1/77)