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FDEE I4 or' State of Florida, Department of Health,Bureau of Vital Statistics
HE L 1 BURIAL TRANSIT PERMIT
DATE PRINTED:July 10,2013 TRACKING NUMBER: 2013098136
1. DECEDENT INFORMATION
Name of Deceased Date of Death
WALTER N DIDORA July6,2013
Place of Death-County City,Town or Location Name of facility,or street address if not a facility
HERNANDO BROOKSVILLE OAK HILL HOSPITAL
Name and Address of Funeral Home/Direct Disposal Establishment Fla.Lic.No./Reg.No. Phone Number
BROWN FUNERAL HOME AND CREMATORY-LECANTO F040633 F040633 (352)795-0111
5430 WEST GULF TO LAKE HWY
LECANTO,FLORIDA,34461
Funeral Director/Direct Disposer Fla.Lic.NoJReg.No.
RICHARD T.BROWN F046656
2. BURIAL -TRANSIT PERMIT
The Florida Department of Health,Bureau of Vital Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382,Florida Statutes.
Permit Number: 2013-F040633-5236
0 Adteh. /I r Date Issued: July 8,2013
��11J fi
Meade Grigg,State Registrar J
3. AUTHORIZATION for CREMATION, DISSECTION,BURIAL-AT-SEA,or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: PINE VIEW CEMETERY
Method of Disposition; REMOVAL FROM STATE Date of Disposition:
EDRS maintains all statutorily required information regarding the death record and related
burial transit permit,therefore, returning the permit to the county health department is no
longer required.
If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so.
DH 326E,10/12
64V-1.011,Florida Administrative Code