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Norton, Christine 6s6 NEW YORK STATE DEPARTMENT OF HCtALTH 4 Burial Records Section - Transit Permit ., Name First n Middle Last Sex 4`4Y L__X-Vi S\-,n e Nord-on F v : Date of Death Age If Veteran of U.S.Armed Forces, a 10 3o Z013 -3 War or Dates . Place of Dea _ Hospital, Institution or City,Town o(VIg.lI ') 3rOr� Ed loara Street Address 'or} 4\1,1/4Asor Nag-sc rtD'M e Manner of Death Natural Cause []Accident Q Homicide 0 Suicide Undetermined Priding Circumstances Investigation Medical Certifier Name Title (2wPnC }lf) 1orr- - b,ct,ynSc-) Ph jS', e\c Yl M? Address Flo C cape\) A ( \.esev\rur.1 �1 vz&o LI Death Certificate Filed District Number s— Rets51,Number City,Town or Village Date 3\ Z 13 Cemetery rematory \1 ❑Burial j © P,nt? V-tieuu CSC' A- l Address : Cremation tk Date / Place Removed g❑Removal and/or Held rt and/or Address Hold Date Point of [i Transportation Shipment a by Common Destination Carrier : Disinterment Date Cemetery Address :,.:0 Reinterment Date Cemetery Address Permit Issued to Registration Number fi. d b Zaker Funeral Home, � Name of Funeral Home�-/t�t,!/')a-r V. CJI 1' c) Address /I La Gl.t�ROe (3+. , ( r,t_t ,Sburcd ,AJew L10r1-- /Q gt4 f. Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, tf Other than Above Address Permission is hereby granted to dispose of the human remains dosed Bove as indicated. Date issued/i)3/-d6/..3 Registrar of Vital Static- ignature} `�,•, District Number Place Cc4 I certify that the remains of the decedent identified above were disposed • (accordance with this permit on: E Date of Disposition II /4 III Place of Disposition ecv L r�r-eta— 2 (address) isi cr (section) ( t lifter) (grave number) QName of Sexton or Person in arge of P ises P, P w Z (please print) ik1 Signature / Title CqCAPrialt- (over) DOH-1555 (9/98)