Vargas-Olmeda, Santos NEWYORKCITY TINE CrtY OF NEW VOW-DEPARTMENT OF HEALTH AND MENTAL HYGIENE
DEPARTMENT OF HEALTH OFFICEOFMUMOORDB
ANDMENTALHYGIENE PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS
ADn13O. 2020 01 35 PIA 156-20-038418
EVENT:ICIECK ONLY OWNS ®DEATH pSPONTANEGUSTERMINATNN O INDUCED TERMINATION
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OY�m011 NUM PlneVlena Crematory Oueelm[ury. EGA,Yet 05 Ci 2020
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SOVERONG THE PREPARATION AMC DISPOSAL Of HUMAN REMAINS VO BEEN COMPILED Arm PERMISSION M
HEREBY REQUESTED he DISPOSE OF THE REMAINS AS VINGUFlm ASKI
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PERMISSION IS HEREBYGMNTEOTOO WSE GF IMHOi10E: TIb PormltknMERMISS wed lION IS e sead of HERBYGRANTED Tme of Mall,and Mandel HYOiera and All has Ben mMxted.mtedned Dr anered In any AblerrnHSAY,,EYE) FEE PAIDAAt DATE O2OB 12�0 By Strum Evial
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Santos Vargas-0ItneCa
SCBGyler Hill Funeral Home
TR0SO120 FH05/CO3/053
Public Heath Law Sec. 4145(2b) 013808
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