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Jenks, Marc C.
A b80 NEW YORKSTATEDEPARTMENTOF HEALTH Bureau of Vital Rearms Burial - Transit Permit Name tiro Mieak Lot 4a Mere C.earNa pale om or Dumb Ap xveRranmuSArmea Fm[ ovatvmC asveme Irani F. ",mmuegn Ibryml.mmetimi W (Itv.roanurvAl 6e sam Steel Aeartse SvamPHa l p M ...... ikon ®xNuml ouzo ❑>s[iaeM �Ilamnibe �Sui.iee �N,aperminee �Rneing w rNuma.Mea m. Uan OW MMinl[enxkr Name Nle Norman flaMY NO tt Cnob SF Fosednn9a.th ree Yank lease urban,robust Pine Iranian Number ReKimr Number c .Town wW Sm sal Ry �Bu t Oa¢ Rmnq.Cm "OrFaixry Hama �ffmmam.m aSRBTu¢n Fine Vlex GxreMy o"u ©Crempion own Tor r, YC* Dumb, Amwsvl Om Woe Ferree r- rmi aroorMeld a Full Aeeres. O N QTmnsponmbA Pou Poimd o by Comm, sn' mail Cana., Common" �Olsin4mrem o@ Coal Aaaress �Psinarmem Data Powo,raiaaress Pemnlsameeto Warren Number Name of Funeral Home erewa Fumml flame as pIIl1 Aaerea Nam F....et Po eo.so0, laM waama Whom 128ta Name of Funeral Flrm Mathma rt ian Away fmWM1om f Nemainsare$nippea.Il Other than Ahrve g Aaarees 6 W 4 PermNWon Is bemby Bnnbgmtlippow Wma M1umen remains tlaeeXbetl above as lntllutetl. my,Nsuea saviireb Way, A vital statistics I ftIFr (EhH Kally SliVK r� ,n asulNi .Epl Plano senlrya 5panp. NarvM enifv Ixmfhremomsmneaeuaemibemixea pmewereaiepaeaf mima,mraereewanmie permltom: WNate,f D,,posnmm Slzllm PbzWonpo.Mo" Arai i i m w ¢ A..,mi lM+Med ro•Ka xamemso„omor PerrommcnaWafPremiss A I W ®� �A rvwai vmaWm Tale Nook Proa5551mAM peoba PobR< HeaQh Low Sec. 4145(2D) .. . � '- 013873 Receipt Hmmantemsins of dlire on� 20� Nne Yiew Cemucry pepreaeming Ihefunemlhome amedo opti yn�mit �oiv1 Funeral Oircvon Reg. at Liccnw#