Kristensen, Alfred DHEC South Carolina Department of Health and Environmental Control
'_ =� - - BU IAL - REMOVAL -TRANSIT PERMIT
/, , .
;11 M. = and PERMIT NUMBER
f DEATH NOTIFICATION
ROMOTE PROTECT PROSPER
IIVISION OF VITAL RECORDS Ca e__A-c.f)
)eath Certificate Attached Yes No
COUNTY
Name of Deceased Date of Death Hour of Death Fetal Death
Al red \K f 1 5Are.0 Sell CPI jID ' DOi3 VAR ❑ Yes V No
Place of Death (Hospital or Street&Number) City or Town If Hospital Death
\�,� ` ,�' ❑ D.O.A. ❑ In-Patient
'Dt e~O mQ.l1((11 C'�r_x v VU'b)(O Ca Emer. Rm. ❑ Out-Patient
TIFIER (Physici ,Medical ExamineCoroner who is to provide Address Autopsy Was Case Referred
o each bZooPnc1ficateC
) �n 1 ❑ YesNo Coroner? Kfres❑ No
-uneral Home or Other Agent F st Assuming Custody of Body ,
44 -54 \ Addt " A tt1 { 1Phonet Dme i s 371
game and Address of Funeral Home or Other Agent Handling Final Disposition if other than Named Above
'e 'ssion is he eby granted to remove this body and upon compliance with the requirements of the laws of this state to dispose of the remains.
\ - i -d .. f :, .-. . certificat- _ -. , -n required by law,an authorization by the medical examiner must be attached to the permit prior
o :i-.*si *,,Il ..'.Or cr-• .tion or burial at sea. Neither eath rtificate nor a report of fetal death is required to authorize cremation of
_.t.4.r►AL `? 1 i!3
>ignature o Regi -r o la uthorized issuing officer to Is ued Name and Address of Cemetery or Crematory
'or Use Only By : olPr Issuing Permit
Vas(or will)death (be)actively investigated? es ❑ No
Date of Disposition Signature of Sexton or Person in Charge
HEC-0676(03/2009)
......„ . „ ,..41
,,, .,..7...„... ,............z... ., ..''..". .. .. .1::1 .„„,,,,........—.,—....,... :1.... ...-.'....,...- _ ,.‘"_,:l.o.`4, -..:,,;:..... . „roe. ,,- ,/
,--!,,,, N'•,...11,!0"--. .;',"IiH' .,.._.%-"%.::::....1.. .S..::•;,•0 ".n.., . ..„,,--7.....,4:-.....7 Z........::\.•,--- ;n"""--".4...., "7:-.4.5.- ; : -%.-::,,,00--,„,,,,o0"- ''n''"' "••••,;"-' 4 ez' '
V. 42'. .7i:',111fr--1';, ,;=.1"174",.....;;;:*:••••::::: 7:•7-..... .1": :'' -77•••;:%...•;;::;;-.4 7 :!:::•;;::',101.7;- •!'. ...1.p.,;;::••••71 7 !! ,..,4010...?..,17,!
\', •,:. , 'Z'''..'"-:;:,3:ft"'''Z;"$•::::" : I";'7AVIr..."'"31 1.74'. , , .-:•: . i --:.•\,:....---;,;:,,.„ ,......,,, ,,...-i i•••=-7.los:,...-- ,,. o ...'":::.,,,,,', ,,4,- •/./
.•;... %.,,,o-,7 ,0 ,...... ,.....,,,,,, -...k. ,,grol.'.;,!,;;;.--",,.6it143. —"I'..-•;;4'4';.41%.,:, f,..0);,.‘,‘,..,;,-',....,:a,,,:r',.:14,;,''<..„?...1.,,,I.• --`"-V;1-11::r•-.:' r •••,'.fte V
Vli'f' 4&:rat-'7-::..---r*Atii •••• •At Nt.-- ,-..-t***ii'' .,.•...............r/''' . .-"1.'-7-_1=-...•1 1'4'N%.... '\''t. ' `'.-1.---=-.....•-:. .• v,,'v
4.>./ --. NI::.-_-_=-:-z---- 1 I I I a ..-.. \11 -:;-'-- ---.5- iiltA1-.==---,-__1-.--.=;-- .4 iti ....41111 -==:----7-----.--=•i/ - #
7v i..--, If
l
YOthl
-.nu:$.€11)14.1 IIIIL:-.:III...
4‘,1:V1,`I‘ AY\iijOifif
*C;;`',-'------ ---
.
1.•:•;,.;Al
......... # „AT
4.*:::•_#:. 44.1'=---
,.;:,.....
,411:::,i0i...
0, 'An
t‘Oir,ik
',141j//1
`7:-*;--er7---------- ......„..„ .,
----_-_,,-,-.,',4/4:0,
1
411(:,..
, 16(19 ,,, „:„.,;„,,
„....,
„.....,..,4,
......,„
..„....,.,.,.....;._.._,_
1,,,i,- ,,
i
.....6 fi ......., ,,.
.t.:.....„,,,, ,,,,,,,„_..,.......
, 1 ....cut -i
„,:,..,,,„), ,
--- -------
E 1
%,..4., ..... .ta
:,:;,..A)) N
,,,,,,:._...::::,,;;;,,,,,,,..,,,,,J.::::•,.........:,....,..:....
.....,,...._ ,..„,
:.....,,
/1:,•#&;;;; ._=-.'------ 1 Qt ‘ag vairak
ICIS?
Alk. 4
liCO4 144/
1 I 1;41)1\ 1• s---1.11, i.:glih'. " ....)
k w
ty!plif
\-- ;--;zi,."-,--=--------.--
.
.:A
AC:: -, -tt,
• ef:::....":30,
....",-,--
----•-,,,,,,,i
litiih. ely - 14"
-.Et-:771111,1,1 1.V bI:::llicL.,.;I"—
'
•- ;:i'"?...1r.:7--- — , • c,4, ,---::;i-:;"::::
-----...........
- .
p2::•:‘
, .
<4.'''.':., -- ' --- • .
..101,....,..4111111. - 11)1,11Ei4A.---
41 z....,.01PPIIm.
_. _ .
kt‘lity 40 AkNijaq
461.4k
/#, ,-". VAW.••• •°'..- .\\\,,,...0• 1" No 101,..,%/ili -›-T.-7,--- ----:-:"".......X. \\I,0 0 111111 >.:..-- -S----(f I\\\, "111111 i .;%-•------ ----1- X •-•, \.'‘
i / \ i 4 ::''.''- --'''-:S • '0.." '. • ;...1*.'''±-:--''''' a '01 ZI:... '' • '''''---'------•':. I -w•-•- • • it---±----=• w...• 'v's x
60 :•••,, -A0....ii,VAillr..A. :,•*0:,.•••:',.."....ril••/. .0".:Li.=Ni. iii"..... :40%•;•0.0.;:•."4....,;'/••/, .09.11.W---miatt...- :‘•\s:s.....ria.‘4%.%%4,4 .der.iF:-Alatt". ‘• #1,
/to ..-).' i'4......rantr.W..:44i...::Z(.4. 7./...1"ei'4:..n.,:::411jr."':•40T.0%.',Vg t:SZIS)://Si;Z:Z....‘11r4::: ,..."A**:'::e0 r''''' .4'W....113:111r''''''k4• \v.-441r: 'A
''', ,,4tr ..01,"..":":401kM:•:1:,1.3::•:•.:4$4..... 11!..r.r.,40,6,1* *-1.7':-.'::.. ;4......_ '4.tr,-__....0401614'\*::::t..::::::':;::$Z7/44 ..N7: -..451'ikk.4::::, ,,,„:,:),..„,.
4111111111.11 .4 %.*••••• it!"''''....".• -..11,11.1i:".4011...--../..s.:•:...4,.....1.:0.t.:r kii.--.....k.,..,00011.."--..00,..::•• r:;"1.:0•••:$1
/ b. ........- --....... .......-- .......00-
,_17„,. 00/ _........... %.....004'__„...........r..........._,.. ...0‘• %,....1-1:0%.%.%.--.%`"ft.....,....7:in. \....A,...ti,,,,,, N.,_,.............4.„,;,....... ,....0.'0_,„,;‘,..„ .,,,„..ik
KRISTENSEN
NAMEAlfred E. Kristensen Age:
Lot Owner: Daniel & Mary Ellen Kristensen
Lot# Huron 8 G Grave# 1
Case: Urn
Died: 9/10/2013 Interred6/29/2021
Funeral Home: Family
Cemetery: Pine View