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Thomas, Charles Leonard
t — 413 NSW YORKSTAM0EPARTMEXTOFHMTH Banal -Transit Permit Bureau dYWl Re erEs Name First Mieek Lag Sex Carets WreN 11wrua Wb DI arms Arm 11 Vmran of N.SAmml Fami 0521R20 WYwn warty vales f flue of Done sommal,iMiulam or z cn.Town or viwg AbmraN Lrtn Aeamm dare Fab Hmptl 9 Manmrof DI ©Namalfause ❑Artibr ❑ xomade ❑mce Dwommime El noise BAN m W Mefiml(erfifier Name Tine O we'm cC MO Mores f W PaM 84 Gbm FMY.Nw York 1Nam LLSM1Ceni([miiko IAs1iu1 NIPapffir Xum[ar C' .ioa'nor Vill GMFM �I ]Ea �Bund Om Cemekry.CremabrywFatillry Name �Emombmem QHYa� Rre Vex Crxmbry Address ©CmmNbn OueenWuryTPn,Nw YM El Dreads, 2 hmovA Om she Reserved �anemr ardrorNNtl How Memm an N QTransmnauon Oaw Toward S as COMM" Bu ma (arty Benimllon � m.mkmmm Bm dm orm Meam Mumma one eenreenAeeaaa Permit issued ro Pe+ymmm harderNamedfuranl lbme MemekG OebrF"ral Me 011am Address f f lehpm St PnenWury,New York Isamu Name of Funeral Firm Maki rg 0oresaw or m WMm hmaim art Shipped,11 Orer than PW.e Atltlress 6 W M' PxmdWmla M1embyrmnbtl btllepow of the human mmadna tleaMbetl above as lntllcaW. Nm rearm ow =O iimimrxdvilal MalnNs N�aF^he°'n°^'�"°"�. oN•*ero Nord Number SSm Fix, rumors" am:YOM1 F ianxvmalifrerema�rem ae exed,m tlenlu'.ease.e«arrwmddinawrmaraw'rmml.i='meon: W mredoimomeaw Sw_iwss Piled OispmHon x± f W ltnrMM nwrrn duty xxnedEeLrnrr verlyd9gm a P'I� _ . z �a m«a,mnu rnk box�Isss lmlMl plda � Poblic Health Law See. 4145(26) 01333E I Receipt Human remains of — delivered on 20 Plvelficu Gmdmy !^" Repwsau,nu the truant hommamed on burial pendt of ial Funeral Dimcwrs Reg or Licenseli