Loading...
Kelly Sr., William David NEWYORK STATE DEPARTMENT OF HEALTH arl� t qq i Bur Bureau of Vital Rhombi ial - Transit P Name NN Middle Than sn m NM omor R6n Ag If Yemen of DSAmedfoms, DerowzpzD eavwm warorrm; lessee Z %mew Denh xoaPtlalmrotwonot C ,ioworVill Hudm FeN Vlq ArtelAMms 9Manbe Pwnw,Xneyn FelN VYq, New Yorh 12B38 W Manre,WRM ®Neural Crew ❑Wool ❑Hnmidh ❑Sumer puMMrmlmt pPanding elumMme: Imiee W MediWGmfer Name Title O May Sbin We Atltlms Grey Nam.Queensberry Tmm, Nry York 12e04 base CMif fled Oinnn Be lee Heisler Numbar Citdamor Vi 5]82 25 Burial Om femmry.[remmrymFrllBYGOVIC Nee pinternment Asian, maby ©cremation oueenaeury Tuner.New York ❑Dornflon ag p Hemmal Rare ae hrtovM andbr PimMHeW bM Murcia gpTeanapowMn Cale Polma a Ly Gmmm SM meM Comer Rmruron ❑Oiaimmml Cm Ccmmrf Aeertu ❑Domineer Cm QmmrYAedrtn Permit lower Hepsmen Numer Name WF,mvH,rre Me ahrerinnenlHwm.inn Ee'nm %a]9 Mare" 82 Simmer.Feet Shared,Nam York, 12628 Name 0 frier:Bank Making Olsgsmm Erna Whom Former are EduppeaL if Diversion Abu Address W u BennleYon Is hereby granted to diagnosis of the hueul Whereas dexfibed above as Indicated. Dam lama Dem]rzpvD pegmmrrl Viol Suemua cy"kii arms"Pcr.an"aray stance) Deno Number sm Flare µnaypuryTmm, xaw Yntt I cenirymnthemm:naorthe mueemieemmee abovewereeiapmeemmarmame rammispermsan: w Nine M Dimanion flip Piece,M Dispoedlon ED aH w ewe] m..+wi ryeawM xamadSemnolPmonmlM1agyFannie ,/ ImlmI r Seem, --e— The �+ ROH+SSS Imml P l of Public HeaM Law sec. 4145(2b) 012698 Receipt Humanrwm sof ✓""� " deljv . � Q 2© 20_ 71 NneY� �� MNrt�eMi°8 We�—qIwmem loobgWpwW Mciw Fuvaal Oim.ors Re6.m I.iceve