Beyerbach, Barbara N v.. .-, .- .1_`_ OF HEALT ` ���
t ; Burial - Transit Permit
- — Middle 2Last Sex
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,_ : ` = / Age If Veteran of U.S. ed Forces
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or Dates
L_ - _., 41180, Institution or r
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0 t',lo . _ '- .use f_ 1 Accident L'Homicide fl Suicide Undetermined Pending
1U.2J Circumstances Investigation
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n tir i ' • n District Number Regi er Number
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Cemetery or Crematory
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3Q''. 0 0 6760,--- ad G uw--_, ..6_„y, 7,
Place Removed
andjor Held
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— Smpment
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Cemetery Address
_, Cemetery Address
Registration Number
.„- _ , l . ; ; t ��,( C) 1130
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-i . •-.:il Distosition or to Whom
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F:" .-_ . �)Q; ;rantec3 to dispose of the human remains described above as indicated.
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,. r -+ec„do,lt identified above were disposed of in accordance with this permit on:
t'K,cal1lbtt Cl:ic:FP of Disposition `er� Cro-ite ,,
(address)
lot number)cs (grave number)
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Title (please print)
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