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Waterhouse, William 41 to C.? ,.,,-.Lyv yrp,K ,,,..,-;-ATE CLIEP.ARrMENT OF HEAL:L-1-1 %/Orli RELL,Lprcis S'ectikirt , Burial - Transit Permit _ - ; \A) 1. 1,1a_rY1 .',. 1J:die , ot alo 'A.,,,%, , rt voioran e.'...4 u„s.v ,A.rmeri Forr,es. car...2,-C))3 5L,0 V't,,ar UT DLite!i [...Jo(v y - pq-77 ,.. 1 DeWitt tHaLspital institutio4LI Or Tirtvin ,,:::' VViage G I.enS f ct 1 iss Street! Address G)...„„s c-:-..,i Jo t,allric'r ri rit--,nti- I-. Nattirai Cal.t.F..e niAcnidr-4-1 :I-1 Hr.4-ntrLide FLI suicid. i Undetermined Pending i Circl,m.sianc:rrs irivnstigariirin ILLI VLIL-L:Lai CiLLLtitiL ,-Lt Wir,...:, Titie I CI 1\1\ i (--0C-C)IVE--, ‘r\i op V iN .. A tAft„,,,Ls ' )Lt MCC Alft a()r i r\l-f\ Ai12- 9, . rienth CertilicaFILL File( i -ishict N . N if7lbe.,..? : P.C.:,:.VS'ZP .<...,,irrtAN I Cn S ( sa t IS . _ irl Datft ,,,,,,,fr,,,...e.ry or prertatorik .., 'L...IBLirtal ))- q- ao 13 Et r11-.Attilirrie.r4 A Dc-C tom allot; Lictcy)sbu nj A) , i Datk? r..1.50:„ :7-',:c-nevor1 ri 77-p„„triciviti illid.-or I leid t OLL-1 l.--- Addr-t-LLL.LL .!,-. ILLioid 0 Date FL.ilil i_ti a= -T -c -,-- t-T,- 1) L . taLI ,,,ir o All S hi ilLnent l'a li`!" Of-1111-k rf!r.-4 I Dr.-.-.3`-:1F1 ill,,, cL:i-Lrrit-1- Date Cemetery Addre.ss ,,,0 1 D14-,,,,,, ,,,,,,t ., _...... Cemele.r./ Address i2 t-. ,!ilyriiiiLLnt r)31f' : '.. Pirturi-rt 15,5:Lod tn Registration Niurribrdr _Name orfLel).41-a! Addiesi. e_kGur-ch a, LK.,e__ 1_,IA:2-er-rAt_.I NY 1 2X 4(.0 i Ni_tr-,e (24 F ilflt-1..i!ati 1 r'rn MakiLig f2Lot...-oiLL.L.iition r,-,1 ILLI ny'VILL-3:-L Rprittains nrR- Shipped ft Citter thiLm Ail:70/e a Atititess LULI _ el' i Permission is hereby granted to dispose of the human remains scribed ova e ditatell. 1 , 1 Date IssiLett //. Or 203 Resistsar oi "V la! Slatstica i Disinitt, tt,ILfflibi:-.e 5(00 i r)l'Icl' rchi 0-c Glens r-ctits.._.. ,... , r:oritht that Lt-ILL, rornaifis :-Lt ttift tiocetchLtre icteLtiriti:ft-i :14-„.-ove ',...ere LI isuriseu LL11 in accorduriLe with this verrhit on. Z U ill D,fito.,., iL,L I 0,i..111JS It 11::q 1 i 1 /S-113 11,-li:,-2 ..°)7 D 1u...r.-„,7;e,11 eiev. uv ett.too-- ',a. , !Cll. Halite o' L.L,:e.xion cir F',LLILL-Lort i Charge LI PrE17.71,sEs Atisitlit,- 3itir.41- i ALI , 13cdt..-iaturL,t_ , ,0,1—, -i ::.C3F-1-1 r,LiBt; :2,2:2.0C.:41