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Meyer Sr, Edward lf-fl NEW YDRK STATE DEPARTMENT' OF HEAL711 VIthi Records Section Burial - Transit Permit i Nam- It- fL- ax4 s PAN,:lit,, i ast ...co -- - NI-C,t4eX 3-4 Mak__ chaio ot Deoratti Aar rt Veteran et U.S. Armed Forces,, 3---LO: — 1 + 2.5 War or Dates i ci,50- ( ce , Place of Death ,-i.'ospital_ Instrutiof iri vilv. Town or Wage G kr\S t-a_i L S Strded Address leAS Ri Us gospdai( . . o armor of Dealh "19 Natural Cause 11 Acnident 71 Hrdrucide 0 Surcidz, 0 Undetermined 1 Pending •A ' rirr:UMStanCTS inVi?..Migatitpri ill MedFcal (7.4.ntifier arne Title Cr tA,21:1,-/LAL.Q_ ka,,Lie ' S F a- 1 IS AN Death Certificate Fie1 t Istria Nurnbe! . Rug,,,_,Aer Numbed t r VI -W kik S t k 560( O i rA r El Etarial Date metery or Crematory t VV--VLei-O CAL*0---fp u rirpmhment c;-'1":" 14 AdnreSS NrierilatiOn CI LA-0--PAk b Q (t) M Date PI Gett Peemovod Z ri Pi ern 0 Vat andor Held 011-1 ..4 ' Add r kr"Ii-S P Hold 40 1 Date Pont l li. L....: r-,-r t ransportatior Common Shipment dy.,,,ommon DpaetSat11 Cemetery Address telhC Canner El Disinterinent Tr-1— Cate Cemetery Address j j Rediterinent ' 1 I Permit Is5nod to Registration Number = Name Ot Funeral Home M I \,t I cr c".0_,riut --14DryL.Q__ oti_q ef. LD-3 D 1 N i Y.S' e-tL 30 I A.CLOtA 1-0,..KL. Kv inf.), Name or F uriettal him Making Disoosdion or lo Who-n i.- Remains are Shipped d Other than Ahave a Address Cr i Permission is hereby granted to dispose of the human remains described above as indicated, f I Date issued 3)r c /i 1 Regis,trar al Vidal Statistics )istriet Number 5C1 t PL.107! 6 CC"-IV S ---- N- V-t--k \S ) Ait' (i i — • _ - --- 1 r:ertity that the remains of the docedont identded above were disposed di in accordance with this permit on. 1,-- Date of Di.•position 3-41 -/311 Place cif Do-,00!--_4(in Azike V.,.:-.&/ O044t 4 ititt.-/ 2- ::,,x;. ,..,! u.11 Cifk , CC / 0 0 Name o extor r Rer.o,i ri harde or Premises - J z 1 rk.,'42,15e;*•,;-on - :44 Signatre ' 1 u . "CI _ 71`.1e Cri-lo,_ _Aie ik-J. ...,.-- ' er,°, DOH-1556 :02/2004)