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Ghirarduzzi, Aldo NEW YORK STATE DEPARTMENT OF HEALTH' ' ' Z® Vital Records Section 44 Burial - Transit Permit Name First �`d0 le Last I Sex i avi ozz.1i Date of Death Age i If V an of U.S. Armed Forces, 011 301 r a.o�� 8'5 War or Dates /0)i -- Place of Death Hospital, Institution or ' j CrownCr C-rs 1'q or Village �er ll ! Street Address (-let' I1\S 410-Serkt 1 Manner of Death Natural Cause Accident Homicide Suicide Undetermined Pending ILI Circumstances Investigation la Medical Certifier Name (� ,� Title lr\I __2 (\a)orvj____Nsi6 a if) i 7 Address !s?© `PQr I L s+r-e.e± - Si_cei )-1 S i a at i Death Certificate Filed rl . District IVumbe Re� r umber mown or village H-\ers �,1\S- �j(�Q I Date Cern t.,.. ^_ E Burial I 10 it.,3 2.01 \ e W eu yin y' Address _ _ Cremation ac..x ,f a daft cs ,,eev Sbk),('`Vi t•)_ 1 ZgV 1 Date Place Riemov d 2 C '; • H Removal and/or and/or eil r i Address Hold Date Pint of s 1 NC Transportation Shipment by Common C-Destination Carrier n Disinterment Date Cemetery Address n Reinterment I Date Cemetery Address Permit Issued to - Registration Number Name of Funeral Home l'/a 1r,a ra 4) iDc ei F.cner / fIome ? ; cif 3l_ Address / L C'&T c.L;. .C1C t &(.4LL_`-)S tat rcJ - r L /,)t' ,/ Ni Name of Funeral Firm Making Disposition or to Whom 1 '0i' Remains are Shipped, If Other than Above _1 $' Address i' Permission is hereby granted to dispose of the human r mains d cribed above as in.icate•._ Y I Date Issued f d/D�/gyp Registrar of Vital Statistics a .z 577 ( 7/-( ' (si ure) . Place L District Number j(�/ I certify that the remains of the decedent identified above were disposed of in accordan a with this permit on: F Z Date of Disposition i o lit (�>� p �.$� Place of Disposition �intV r../ (Ermatdrfi%-./ W (address) Lei CC (section) /(lot umber) (grave number) 0 Name of Sexton or Person in Charge of Premises ,(t, f ScNntft Z / (please print) 141 Signature L Title CeiPl f OL (over) DOH-1555 (9/98)