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Sparta, Susan Ruth
NEWYORK STATE DEPARTMENT OF HEALTH Burial - hae$it Pe11111t Bureau M NYl 0.e[oNs Name Tom himus Ian 5e'a Susan XUN9 W Femek Oarenl aeM pp xvek.m WUSMFke Fngf. S'lMtlta BSYeen Waroraan f Fall It Vem XsspNEIn,tlWrbnor W Gy.TwnorVilkage el,Fww Ntl Stlrel Mem, 3SB Push Srem M],xudam FaM wines,rkw YOM 1xIDB p m nna,of cashM1 © naual Cause �nreieem �lymglee �Suom, �Dntlekminetl �hneing VGnumname, Wp MhedKuCerrfler Name TMe Form lar}q Colmv eekm a1sw..r Man SYxI.Iwori F.Fswme..ARM Yeah lxeae aaalxcenrvlFime 5innnxummr Ikglm,xumm, cry.mwnorvm wmmFukwl ,r , ❑Burial Oak mmelery,Ckmno [iliry Nam �Emomhmnt Moshe; FakY Corrosives f k C]Drumm ammkwryTown.xa.,vm ❑Drumm o O Remove[ win win harnessed F anal,, anvm x,le Hole Mek„ ❑Tm,mlamon Sam Poinlm by nmmm Shi mem came, Dmaagnn Dinnkmm ora tamenrYadeka � use; mem ora EenMerY<eek„ Issued balmm mn Number uamenl Eunenl Hnm Me warp Fvemlrbne.Mgle Dian Week„ ...Main Sl, FYVYM, f e Eu eratFIrm Matlpp,,h r mWhom ..are gM1ppM,ll%MananM,m"does M W LL Ppmleelon is hereby granted go tllepow of the human mntlne tleecrlbW aboveulntllumtl. e lvuee 'D✓eB'e(Qa pyinry of YnalSYlink, C�rumAOnr{r 12&meva?yJgseO/ pywerel Dxlritl Number am Plus, Human Fme MFpa, Xm F «nilx,nut the kmKAS 0 her eneemrihiNlieabre or,eumW of in rmNamavah[hu puma m: W car,m Dissuade, . TIN plakmDxpo,tlmn F a e w c pw, r ak mael Srvameolkmnar Perunin[Fasgol Prtml Z apYl w Signature Tale /h%,ATRL Dan-tsss IN/tel Paul Public Health Law Sec, 4145(2b) 4 a 013875 Receipt Haman remains of 11 deliveadon / /JQ2 2� 20jy wviewCm i� mew Oe wwi FLnael Duecwrs Reg, or License4