Brosseau, Marion it
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Viial REE:c3rds S v'tlurl; Burial - Transit Permit
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Dates i=f Gem-rtti Aoe 11 Veteran of U.S. Armen Fords.
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Ply e 1 Death .r pitial Institution Or
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ICI f49, nor i-f Dean Natural Cause . 5^s i ient " �t r mscr•iP uicif 0 Ur fermineci r0 Pending
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Death Certificate Fiied(�_'�\)1 p +^� ishict Nur be P' xst?er Nj tb r
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®a trial Cain
r Crematorye.
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DE rirfimhment
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Cremation L �.�� . P1`Jr L,� I
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Diat e lacy+ Removed i
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atc + =meteryr Address
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Its Lerneteriy Address
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tOrrr1 t Irt;4141r! to Registration Number
Name or Funeral Hume OO I . .,
ricicil is5 ACIA r-c h a. L..a_k,_ Lti 7.ex r\-Q.. Ni y '
1 Name cf Furlei al Fr rti Pialwrg .)isuo tior;r1 to ` ,Ilt:1
'- Remains are Shipped. it tatter then Alm ve
Permission is hereby granted to dispose of the human r as s cider cave sn itsrtede
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Date issues l-0,4'Ao l i Rek' is rer of Vial t tistic . i
Disirli-:, Number :4)IaiM r.. 4-. L.1.4 .
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rrl4y that " 0 romans if the Aoc:".dorl' ideGiril cd ,it.: v ere disdoseu di it .ccor yaneee with this permit on.
Lill Da +.' c4 Diz,positIon I41114' riai 4. ,:si.` ..'IS,.i?i:;,.aiCi'"1 'Fa‘ L IY ,torfu..-
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[, Name o° Sexton or Person in Charge ::1 P-rem_ses ddrittric.�tNN/i i
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)DH-1555 02'2OQ41