ST. Laurent, Carol M. . e lbl�
NEW YORK STAR DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau AVihl Records
Name final Made Ian Sri
(sesame.&ls
oYea Rtln Rg It W erm of us rimed Fortes
apnamvn ba vaam Wno,D",
i- Plaed Omm wwiMKl,odd'on„
2 Coy,Town or village, No Mw AMreas 9rYYeNvMx
p M,nnerMOeN RNMIAlca:ae E]Auldem Homi,id, EjSualde Lj= ClR diiq
W MMkaladdler Name Me
O cm a m PA
Memo
s s uwmeq NI A mem.Neer ron Ideas
O 0O ,Town,,ViR,m,
olnwh 0,Wks,RI nn number ReymrxunM
NYny 1818
Burial Nme GmxeIs Rmn,ry or 4KIUF Name
❑Em,mbmml mart Pm.ume Famous
�crtmai„ Mdmbary Tmm.xm,vu
w,n
Rama,' om pla„xmo..a
aad/,, a,aNrxefe
N Wld Address
O
q �l comma„ °"` Poald
S bvammm„ SM1i m
pnt
Grne, Assumed,
�Movement Dee hmess Adem,
ElNe, m,mmt Data E,melem Addr,"
Tema IN Pepfslmo,Kumar
Named Tum AH,me eM,mmimam PmMv certln< Imam
Mums
aax Made Am,smMma sumps.Nee dark lust
Name d I' m.-al Nm Assume Depa m m m wave
f Addresare SMppe411NFer1M1n A6ire
•f Mdrtss
W
Q. Pmmlaslm Is Nnby pranlsG to dispose of Me human romtlna downbM above as intllcsNtl.
Dee Issued oM:aspzp Peynre,dvbalsnm.s m,.aas gasr+FaaNm,;m�Mm9
ommn Number bml vase Abme, x
i mnxvmMn.remamsof lnedmm,mu.,BfMeabmrtmrem,m<dm m.,d,�,ewxnlnismmbm:
Wmxdwsposido, 52D Naemoisedem memo
Is
W
0„1
gNamedFSmxwnorhr,,inChw, was
IN SRI (L49 Me
DOH1555(07AlP1042
Poblic HeO it wSec. 4145(2b) 012800
Receipt
C L1Luwenf y °
Human mmvns of (}' J C) /' delivered 0� . MI_Zo
My ce M w
M� Fwnal DirstM R Rcg.eg.mlxwe