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Thompson, Evelyn R. #9'9 NEWVORK STATE ds Burial - Transit Permit 593 DEPARTMENT Bureau dVilalRttoroo Name FrA Middle Lan 4e onesR Than pn ymeb was o1LMM1 Add If Veered o111SArmed forte; emi mYam Wereroms r— Plae It pour xo:Pml,mniWlion or Cityliconno,lorlse JohnsW Tom AreetAeen:: 13blxaleLNOM Goµ M.nlleroL CeMn ®uuurat<au¢ jAaidedr E]xomiah E]SukNx Elp,dmmired 0 Pending rirmmnerse: Investigation WifialOubler Name ➢m L srenM ME) Town. 112 ad mal Fad,.Idnm..e Tome rww v,a dzav m ,mosenTrcm Fled marin Number &gimrwumFer C ,Townorvwt wmclew I � I is BurW pm tommry.CremearyarixiNry Haire ❑Emmmmem C63V�1 Pmv crwiHlary Address pCorrelation Osmanli Toom,man yords Eloonms" o F-1 Fa l pm aPlum ndf Pemcwe 1— and/ormNorxeld N Hold Aaartw O H Demonstrators(omman a Pnrnori °ne Pnimm a sniPmem order Dminman Apia rmem 0nd omeMry Ada,. 13sumrmr pne umxry Aedreaa Perms Issued Reginrauun Number Named Eunerallam Anlarrwerexome mtw Add,,, forni on,nb a 90,Indeed Lake,Ni You doses Name of funeral firm M,mg Oiposi on or Whom f remains am Shi SI H Other am All Address BE Q. Remained n is hereby gmnMd W di"om of me human mains deed abed above as lnElnstM. pm Issued 01J1=20 smear m vital unions rNetAlunQ Lorah rictirnlul"higntll finsi 0iddinwumber Sdis Plan mM com, Nee Yok Irenny ri As remains of Lit madendldenondali were disposed d in cardamewitM1 NU PamHon: W patrol pisposilion �yJ %aze of Disposition {iaiyy p,� W xmW lMnwwerl anions Ner Name of swbn or Perm,in Owes d Premif e 2 m sgnmure rnM DOH-dsbplwori Public HeWU law Sea 4145(2b) Receiq 012776 Human remains of - tlelivged ou 20� Wm view Cemc� �eiL R xesentjeg��e� Funml Uirenors Reg, wee mtl m [unLPemti� N