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Johnston, Shirley Marie
2'F szo NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit BurtauAWlnIR«was Name R9 MiddleM Lan Sea SM am JRrebn Meol Des, AV IT veceranA U m012UR Wamr Ow Mae DaM �veem tbnorIy� 0A.Twen or ellsie as sembpe T"Palllp Manner11 Man M Nauy Ca.ae a❑Maihm 9,Nitle �Unaemminetl �rtrmbgpInnnlW MMim Curiller New roleO 9 OlbAmmo211 Cho"St,STog SSpanpa,M"York 12MMCeara Celdn"Flea Rryner NumkrC ,Tomnorvlll s STf Bung M1Me PmeleME LMen or ibAhle Name �Enbmbmem OlelY.1J qre Vlm LMnamnum Amms ©cm ran QuwNwy Tom, Nw YmX ❑Nm aam oQNames CAR fla Rnmtl F anamr a�wm x.Ia N Ibltl ALama O N ❑Trwj lion Nk %i m ial em Offp Ey Wmmon en Deminmbn psimemum Czu Cemmer"nss sameness °"e Cenlwe/Aeertss Perf lieuetlan Nejanflpn Numkr Named F,mm Nmne GMmFUMMIliamb" M281 Aware, 0Ma n Slml,P O. Sm,el,Mtlwn Ease,Nox York 128% Name no fnnern film mk,%oifgr bmorb WTm t RMA....ffheped,nolbmmanMone s lesson a w n Pamliwlmn Is MmiY BranW btllepor Damn M1umvl mlminadaamibad above as Red heated. Dalelssmtl RRlnmrplvxalwllMlra xLnm ntrmm(Iaemm�eeNrs�re9 nea,.f um;m Numkr once sarmag,spbnaa. xw ma renvy lbm me Memtlna a the ameaene iaemrxJ a owe agarea OF In mrameeNM1ilm lermiln; _ WOaleolgepwlmn Also Dace a DW,Abn s o1w w N Q ` re xmrtaxmnw Mason m[n.sa Pre J 9> m na WN-g551O2AIPla2 Public Health Law Sec. 4145(2b) 012613 Receipt Hunnanmm sof ( . .l.oea Jc' debvenMon , 20_ Noe Yew cone Rep hog NC Nnvel home oemM pp Lmial ivmit 01hciY FuoeeW Dvatat geg.Wuva N 11' r