Loading...
McLean, Anne 4 eit NEW YCR _ `ATE I AR MEN Ex OF HEALjr. 36c Vila' Records Mlrirr Burial - Transit Permit M Ail c Lear)Angie - 2 o a?F 0 D tt-I a vp.z. 11 4 1 '- 2-o/c9 L59 Ii,or g 1 ttes A/ , . aF— Rape: al Death -. . ri€9 ! t1 r uI lr t uii=F ` ! �5 �t�a l'A r t� tt7ra : .`a . a. jr+"t Cn . t t3G17? OFs GrT r { ig inq LI ...te .tsmstr'6lytitt= l s r �i r tla.al, ill i ';:147;ai t --r r NJr e Tar CI - _ Jphn itDu✓ -er u, M0 Death Cer1lIc:ale i rid Li�l iet t;i.i, ibi.i, .r „ter, 1'4-driltDi, : tr. ,r. i gar vif r€i G� ')3- 1-.al 1ST. ...iii: (JCf)0, 9l O) LJB Irr al Cl1r= �p i ? f' Cremator.' CIi rrr;onfi rien n� v �- Lt1 l✓t �L�(,(1 V✓� . AtutirtttG 'Crean-Then iit C X �t t' € t rat �.'r t .rrj ur I leid r ,ri,d d DiAe t'. r;t _ iv Cil l Tfci,i,pt.) ti;3txi;(; S'i+t.merit it.3 b ` Currirrtorr €:.tea-n�ali;:n C rrir r Date Cernetery Address ,D iv ftirrr FIR iit tt11:-= C-"1e1erar Address t EPA rm t lrr i. d tr Registration NUM L.r_" E, NLalti F` t� Lt UUr>°ral Horn wB� ,, 4_ �,(,j't,Q r a./ Home__ l ti c (/s '/(/ Ad l z� c h 66 Low..._ L k!S Cher � u z�-�, AA,/ ,+r..l,"•tom Or t .i.`ir>rt) Emit Milking Dir. .rf6.tioe of to Wlt_i ) Anmairts are Shipped, d the r aN i i z C:a^'nr` er 9 ._. r IV 1 Permission its hereby granted to dispose of the human remains ,escritbed above innd c t# _ , Date: l'�si ec (-1 ( za t /6 9 tegiszrar = f a. tell �I 7tisiA e: " �t-) D ' 2 tt { Isirli- i_tril-,r.s U0 , Pl;ar,. (-) Czv.S rG C 1 is ej r:oitrfy :hat till..7, remains ..`t thc. j.!4;.,.t. r"a`. Ef..ri.l, f-J .a;_ � en2..t, tlss.>.:`e u::. F::ieiii:e l In aLc? iiith this pc2rrr@i`.or. D4+7ste of D-,pui;itJt i (1/it l�/b t 1 ...e_' 4. a'i14ie,i.?- , ' -° 1-'L— Cm, - f La ZI MI- CAE fi / la t4l u o, a xion cr P._r' on It'i Char ! i u-rt c or" CN Z Aid 11 �aiatcar *M1� _ _ ,.._ . i ,. -Gal-i-1555 a0212004i