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Montgomery, Helen Mary
# (003 Bureau tl NEW uOPK STATE Re oEVPNiMENi OFNFALiH Burial - Transit i4nnR BuauViGl0.emrEs — Nam Ism Miade last 0H9mTYnM M Ya S in:N fortes, F m OareoR Av N rtaN Measure %aced R Nmpra.lMaWon o, m Gtr.iawnor Vi (irvrvi'erwn Smermmss &am Valley CdlYrb NtluMbYo:aq NmYry o M..md%aM NNabmCause LjAwwPwq ❑xrmrtiae �snxix �unxMwi:we �wneim acwmw.nrc: lme W Mediwfe:ma Name The Ganeeea. Ads Address in.Hex rM t ffiV (Ay'Torlif are fad@aMxumM Ip®mrxumh, City.tornorWl GremilN 6AB Sa uNujal oak femnery.(remamrymbiory Nm:e �E,twn m (WAN]0I0 PImvl Qmwmy Address ©is minion Dmwmryimr.x ero:a ❑Duration onArm. nArua Cm weRemo.ee F aneror mwwxew y Hold Access , 0 w 0lrarslonaur om wtmd Ar mmmor ut :rex orrar cednmmt ❑oiam owe RmMerf Addreea �hintermenn om RmMry Aaareu h,millfauMm &(IMxmr Number Namedfumnlbme MmmdoeM F,,mlHvm 011]0 Atltlreu 11 lffigLte 8l Owvs W r.Newyork 131101 NamedmShi mAMf':N%apmitimnmWMm f Address reSAige4o%MrMm Naae Address PamriWon Ix M1mM1y BronpN b alapkw of Ma Aumm ramalna EaeeNM1aE Wew u IrMInM. oM Issued uW&^Nzo xepowrdvmlstwims r rr'^V°x1sm Zass'""'WAr.rpwA Nwml D,l,d Number 57M W+e Gm,We. Nmrak Ircnovmwme retmimdMeaaeeemieemnkeaeomwere aiexo.dolirarm:emr..nn Mieaerrxor: owed Dvsp,,mur 4 5 u y%rcdrawwwion mwm Accrued ammml xamedswmo,rt:mnin fA. d •L ' /, IN• MV sNrmre / mtrca rm �" ooxd555Innnetd2 public Heeltb Law Sec. 4145(2b) 012795 Receipt 1 V1 Human mmaire of \I delivered o0 � _. 20_el mew Cm�emy R,pmwaunB ee tnneral M1own navelo Wk .t Funeral rereceB Rog,or ldcer a u