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Ball, Robert L.
NEWYORK STATE DEPARTMENT of HEALTH Burial. - Transit Perm Bureau of Vnat keooms Name Flat MIEEk AA 4a NoOM L Bel Omtol noun pye If YHerand NSAmN forteF Memo 08,1621 157 man Wear Oaks f Norm W Treat HinewaLlnslilNion or KILLCiry.Town or Vill 9y SummeA ams Saremue Hce W Manner of Beall E]Nmral Came ®MidemBecame E]Suioitle E)Nademumd It V Grtumnarces InwAg ran bRom[CeNNer Name Title Renominate Cmmmr Adnme 91 Wro]kwn Ave,Sma cea Bpingc Men,Ych l] Ram Cenificav Fred pnricl Number RegiRrlumler Celaenor Village sw 9 eWt I28 Burial rare Cemetme Lemamm or Leafy Norte ❑Emombmen obtflrzoan wwcrammy Address ©cmmMun pypy[um Town,New Yµne Damon 20 nhmnat CR Pk:ehnarcE and/or mWrHeM raw Manor Em" Pomtoo is bYComnoo sni mem Canner Rental F1Oisimemem Brc feamrg Mere.. Miramar orc Certmern Adana moral lsanedTO flryudon Number Name of Funeral Home 8rowm FuneNHort =11 Addrca PO Cnurrh SYeet PO Bae SW, Luke Wssvnu,New Vw41]818 Nameof Funeral Firm Making plgositnn or w Whom jea &mains an Slimed.Il Other than AWrc Mdma Permission is baraby great mtlimotoal of Ne humor rantroodurfar tlucribM abandon u Brilliant Dee le:ued Preal N' gegls4arof VNal Anisits .tlnf4/FmCr(FJaeodaly9gl� lse+mwel Cirwn trader a.5al Nam Suety Swlneo. New Two mruy mit the nmelns of rile decedent nonfood abed ware dimaled of In xmName with Nb porn f ne rooed Birition qjmjm vlaadeiea�nn va w neant t/�.awmi 4nw g Mm m mnnrR nincha v all w ad Sommm rMe OfAmorl OOH-15551Nhal V I of panee Heelth Law Sec. 4145t2nl C 12733 I Receipt Human remains of: delivered on . 20 fine View Cemetery tame named no Won] Won't Mom Funeral Diretlnrs Reg.or Wreose% . .J�