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Hornicek, Marion M.
v8Y/ NM YORx5TPTE DEPARTMENT Or HMTH ` . � Burial- Transit Permit Bureau of WNl Retards Mieeh FO Nam F Me Man on M.IkmixM Data of RalM1 Oge nvenranduSNmee Fwtax aemalmw e)vaYa WardOms Plaed Rsn etallanmennor lrzy a ,mamolv;l raw we Mrenaeere:: mae+aae Mxmx F...a p Mam,,mNaln ®NNuraIWu �wWem �Numxi* �LNh �pnewlminea Pending w GrtumsWnxs Imeni 'on IUjI Mee'ralfaener Nam TNk Gilms Hmam nem ,, 112 M B_v.1 NO,"madam Taea Nam Yaa 1m Pmq Xwber Wea,Xomkr RmAC<MKm RV Y55 m [ ,lormorVi dY` CemwrCremamry a Fainry Name � 1. Budal awpypyy PMVbv CanmmHum �FmomAmem pHereu ©Uemation gwetlayTwm.IMYaa �PoaMon o Qxemmd Dm anebr M HOW AEE1esa pg PomA by COMM, a,Mn wm S Aviemwn peAYwM Omer �oisimamem Ow li^'wrYMeresa �Px'nmrmenl Xne rmmNM1aeeresa IY xamAer pemnnlameem mu1141 NameAPomil Mne a.mdaYMmm FurYXw+Nr Neareaa Name FumnalNaan.Xw Yak l3Hi Named Fuleral Fnn MliigUstoaMiamorm WAom f Remainsare SM1lpµd HOHrerINnPmn = naereea w u MMm11MMonb M1MMy9m^ebb°tl14YY eI MF M1YTY nmtlna tleMMJa14s+Mal Intl1YM. Care l,rme Dlm N Peainrar of Vnal sulmlt, ejdda,C.L"lµlntmvmRY 74 r=�amr _ olman Number sau place NmNPma. Xw Yw F IannvinMlAeremaimadma eer.xmiamurasema.ereeiawadwe,taa�e.�a.HAaniaprmxa= Z Care dV podm jm %mot ymposuom XmeM N1 .ax m.-aaMn 8 Namxd4mnarhmnin CAe�d aeaktl pYmirc TWO (CW1 siwwre /�p// pox-assslmMplAa 1 Public Health Law Sec.4145(2b) Receipt 012684 Hluam remains of ^- = clelverecion , 20 P'veVIMCemCTwY WMa ReRmxm } M�xN Direc on Re%ortiren�X4 % area/�ut