Loading...
Rock, Stanley Dale � 9�6 NEW YORKSTPTE OEPARTMENTOF HEALTH Burial ' Transit Permit Bureau of Vogl Records New Pa Middle Nn Sri SraNe WN Rork Oneal RalM1 Fg Il VeteraDidn' Nmed9M OLO6ROM ttYwrs Wazar Ones 136 .1 R20 F Pitted RnA 1MSPnakMstiWionor 2 CM1 .imvnorm GYna Pak Be A' m5a Gone Fdb lkepw oaemerdwan ®Naualrens ❑Amean ❑fbmMMe ❑miaix �Nnenenm�wd �vennrg w cNnmm"m Imm�i w Mmi[n GnRur xame nw a MCMn LYMVAr MG Address 1 W Fair S,Camara FOB,Nw:York IMI Ras Cenlfao FW OisNn NumM Ps®MNumEer CON.Tonmormilmer nYre FYo I smi 3m lama Ibo Barely.Gemaore oriclis Name p UM2020 PYa one,Ceremony �Ezinvem insures OCommon, pyanWry Torino Have YCA ❑wm =O ❑oomrel wo Hanemann! F and/or amino Om Hold Address N QT O Poimd aptlo p Brunei sfi mem Omer oewnmon ❑oiMmemwg IMM wmerery Address ❑Reimemwm ore wmNary Andre:: Pormltlsmedb Reeisealwn Number Narn"Funeal Home Mealmn Forma Hme.Pfayle 0107 Address 123 Mai,K MONe,New Ym,12M Name of Fmenl Arm Making Oiswsilbn or to Whom f Femainsae Al ,IfWw hm Abrc Z Address w u PormiWmf is hereby gremetl to tliwwee of Me M1umen Breslin tlaemibetl abrw as intliMetl. onelsswW w'IarzWo RisrardnalNmsks 'AofrrlAn6 pro EF4ttT°Iwaj'STpre6f ¢bwmm Oisild Number Saml Nxe Geer Fah me York only miHe remansd neeeatlenlIRtiFN abw were dia medof In a¢wdmne am Ban swimmer Nmed oiaPo+non 4 All frio Plaed onaweium p 1 (Aim"I w � rwav 4 Memwwl am- gNmed inn, mine �d�rmi / wNemtnre DON assslmlll)Pldx Nblio HealN L w Sm 4145(2b) U 12699 Rweipt L6gman wmv s of detivc c oe £f�lG � Yd , 20— i Flnelfiew Cew.M' RWme^tinB Ye fun<N oametl OSiniN Funnel DireGcrs Neg, or W