Faxon, Ralph N
NE",6P1'CpK .STATE C E PARTM EN T OF HEACH
Vital Reaords Setphur Burial - Transit Permit
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Cemetery Address
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Dati, r-p.metery Address
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1 Permission is hereby granted to dispose of the human r air s described abova as indicated.
Date issued /DI Ja.tie:)(_?/ Registrar oi 'vial Statistic:1i
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