am

R309, 100M-10-80-156788 | el : ) ZY “ve q ji

No. eo} fee be ean eee ene Sd Aaa LO Bs

BURIAL (OR REMOVAL) PERMIT URIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

BOARD O2¢ HEALTH

: : to Issued to eee 4. ° 4 ~e LYWrAalarra 0,0) Sulei6: 6: 6 so/fu 0! 6010.6 bee melee (Office issuing permit)

SOUT 4ABORO

t ere RE EN SEPE CTC ee Perera re reer er pee Mass. Name of Decease Ae iy (Wowace. horror ee L.. er : C. LORRAINE KELLER .

> of deceased ..2 2.7.0.5 boo Arie Phe or ener Se eee

U. S. War Veteran, specify what war, organization, etc.

Place of death... 1... J mnie : Rel Dee Msbnengl oe er

ENDORSEMENT

(To be filled in by cemetery or crematory official)

iereby certify that the body accompanying this permit was »sed of in accordance with its terms

|

authborough.Rural.Cemetery...Sauthborough,M

al (Name of cemetery or crematory) (City or town) ener’: 18,.. 19.90 A ae ose ij De hit at! aso Reale f 4 Date permit issued . yx. eT y L A.A. Btisicsis be <I /f bfied | iby ee Ce) of edi ge dn. fa TY eee * ® “(Signature of RZ norintessdeait, ea or cremétory)

Certified by ROTI. 0. ee eee eee ede pieieie 9 ANION Coe e eens M.D. If there is no officer in charge. undertaker should ia) ‘and return this stub.

Che Commonimealth of Massachusetts

DEPARTMENT OF PUBLIC HEALTH REGISTRY OF VITAL RECORDS AND STATISTICS

OFFICIAL BURIAL (OR REMOVAL) PERMIT

(issued under the provisions of Chapter 114, Section 45, General Laws, Ter. Ed., as amended.)

(This permit can be signed only by the agent of the Board of Health (cr in towns where there is no Board of Heaith by the town clerk) of the city or town in which the death occurred AFTER the FILING and acceptance of a satisfactory certificate of death, prifited or typed in durable black ink.)

(Address)

Bo eee Peper hott ~; CET EeePC EET OT ee , and the interment (To be filled out in case of removal)

at. CRP. ~ 12 dtd, fe sieeve acini te hie OK bed wens «% Cemetery in

body Pe cin Bh Ax, Aen

for the removal from ... ./.

, of the

sated flan oF who died pores ey ee Api reegred 2 19 AQ (Give full name of deceased) (Month) (Day) (Year)

Ah mukalek ata YOAPS, oes ccccvccccsces MONtHS,. «00s oes ss scree days.

ee \ ae ee were tnt on CIS Medan

If a U. S. War Veteran, specify what war, organization, etc

Residence at time of deat’

(Signature of Agent of Board of Health, or, in towns where there is no Board of Health, of Town Clerk)

Reoo Black wh mee ie oe

PERMIT

BURIAL (OR REMOVAL)

This coupon to be returned immediately, properly endorsed an AY (Office issuing permit) City or Townof .- Asin ; a ~ . i chun hs aes Mass. Name of Saag. AASE: cue . Bhasin Sey:

If a U. S. War Veteran, specify what war, organization, etc.

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

eeeeeeeeeeeeeeeeeeeeeeeseeeeeeerseeeee,eeeeeeeeeeeeeeeevee eee

(Signature of Superintendent, cemetery or crematory)

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788

se@eeeeveeeeeeeee ee eevee

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

eeoeoveovoeveeeeeveeeoer eevee e eee

ceoeer,eeeeevee eee

eoeoeeveveveveveeveeee eee

Interment at Bis inovmte ested, Wo DONC ED VV AS Oi

Certified Vs ~ Ne) OF ati bat, .. M.D.

309

| 2 ee) Oe Rs |

BURIAL

| PERMIT | |

(OR REMOVAL)

This coupon to be returned immediately, properly endorsed

to

(Office issuing permit)

hace ity or Town of .../. URAL Let

jweeoeree eee eee eee eseeoeeeeeeeense whee eeeeeeseeeese eee ese toeeseseseeeseeeeeseeoeseeeeeens

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was isposed of in accordance with its terms

(Nam cemetery or crematory) (City or town

eeeeeveeeveeeeesreeeeee

cemetery or crematory)

If there is no officer in charge, undertaker shgUld sign and return this stub.

R309, 100M-10-80-156788

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Issued co fee ee cok eee er ee ee ee ee a ee ee a ee Vw Creo

Name of Deceased .

Date of death. A UAw... 9 aes ay ; Ge ee Liner :

Cause of i /

eeeeeeeeeeeeeeeeeeeeeos eee eee eeeseeeese ee

ae

| JRIAL (OR REMOVAL) PERMIT |

| This coupon to be returned immediately, properly endorsed

ch * Irbaoet (Office issuing permit) oa Town of «yA AAT Pe cece cece cece eee cneee Mass

of deceased Hondas = H. oss eee’ LY i ¢ SO

ENDORSEMENT

(To be filled in by cemetery or crematory official)

sreby certify that the body accompanying this permit was ved of in accordance with its terms

RURAL CEMETERY, WORCESTER. MASS.

Bee os oe ee ae tied by ...... LUitheeey, T.. LOM OM,,.

| (Signature of Superintendent, cemetery or cr

| If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788 ge oe 7, a | ee O4+.—~72 aoa

|

BURIAL (OR REMOVAL) PERMIT RIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

4 to = (Office issuing permit)

—_ Cd pee ot Pi. sodnee teat Mass. deceased S od.epde Rowleng,

a S. War Veteran, specify what war, organization, etc.

ENDORSEMENT ate of deatn-.-.-.-*- ok Rilo JO reese ee eo ss Oo be filled in by cemetery or crematory officia Dat ‘Toon Qn on | Nett onde tis a (To be filled in by y y official)

y certify that the body accompanying this permit was of in accordance with its terms

Cause of Wn Wend bie U eek wire wa redhsuke des baane Tee

Interment at | iiiamatatecte acu ses a7) : ) mA... or town)

eeeeeereeeeeeeeeeceo Mec ee Cee ese ee ee Me ese cece eeeeeeeeeeeeeeeeereeeaeee

Date permit issued wt Wg iis i. i 3 © SorerreteirT I by GEORGE W. MERRITT

| (Signature of Superintendent, cemetery or crematory)

Certified by..... ne F Ro SLR. p- A OR A phe Ss bits Ae M.D. here is no officer in charge, undertaker should sign and return this stub.

\

R309, 100M-10-80-156788

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Fanbunradbe. Re. dacaledy,.

- ; y ' ee ee o, . a ‘ rie Cause of deat Ned orladix. «a t ; \ Case DN eS ee

Interm« tat k paral. Ore crsading .Wenceston ete eat

a j (-) a er \ te urAcah Léa Kenal_ \ : deTibevogl

Date permit issued , AN

eceeeeeveee

[nr [rrerren

Certified by We... IV CPG. . Giiwanalce cee wainaeqnnas M.D.

BURIAL (OR REMOVAL) PERMIT

This coupon to be returned immediately, properly endorsed

(

Office issuing permit)

vor Town of «6 NOONAN A oc ccc ccc cece

ne of iccoeuanl homeo. yena ply

eeeeeeeceeeeeeeeeeoeBeseeeveevee

ENDORSEMENT

(To be filled in by cemetery or crematory official)

hereby certify that the body accompanying this permit was iosed of in accordance with its terms

RURAL CEMETERY CREMATORY, WORCESTER, MASS,

Pee eee tees ee eeeeereeereereseseseeeeeeeereseeeeseeeeseeeeeeeseeeeeeeeeeese®

ee MAY....2 1990

tified by ...... Ee Bt). My. | (Signature of Superintendent, cemetery or tt i Gi

| If there is no officer in charge, undertaker should sign and return this stub.

«e®eeeeeceeeeeeeeeeeeeee

R309, 100M-10-80-156788 ce ct age 90 wo. @.—7..9.0....

BURIAL (OR REMOVAL) PERMIT JRIAL (OR REMOVAL) PERMIT |

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

mae (eon d us

(Office issuing permit) Town of .. ko Pe PP bs bs kako daevdee cus Mass.

»f deceased dLbruland: et AREAS eee,

. S. War Veteran, specify what war, organization, etc. ¢ A) *

Age.... es eres ‘ae tha wnb en aa yo ee days 2 Z / Wat) 77

ENDORSEMENT a3. - ual ( ‘ 4 : Z. Q 5 la ll aaa aad (To be filled in by cemetery or crematory official)

, . reby certify that the body accompanying this permit was Cause of de DCAM IO Pipe ps j e. Nash sed fae. 2d of in accordance with its terms

Date of death ¥. 7!

eeeeeeeeeeceeeeBTeoeeeeeeeeeeseeeeeeneeeeeee

(Name of cemetery or crematory) (City or town)

AY. .26,..1990 bak Bideshoviwss er JRE bain eri iakiaes Penk

f

/ O “ , 2 a ) f, A yj te La zc J rg Y pia eeehuel ont ied by hie, bei x Malti. fi (Supt.)

ature of Superinte ident, cemetery or crematory)

| ne (Sig Certified b “ “ane Lr) Cece e tet PEW GTM soc cdcsd we °..M.D. " there is no officer in charge, undertaker should sign and return this stub.

Interment at....

. . conti Date permit issued .,.

R309, 100M-10-80-156788

199...

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

eeoeoeeeeeceeeoe ee eee eee eeeeeeeeeeeeeeeeeneeee eee eeee®

Name of Deceased . THOMAS jake tel o4 ‘4 FERRIS

Age coccee ZS +» VEATS- cee eee r cece eees MNIOMtHS «* + sc cccsecces days

eoecoaoToee © ee eeeeeeetsceceeneeeeeeeee eee eee ee:

|

(OR REMOVAL)

This coupon to be returned immediately, properly endorsed

to, —. BOARD OF ESRI

(Office issuing permit)

; Town of M4 0146 GM bE 4016 6 010 8 ob CWia se ele @ 6 6 6.0 O's Sib BOs 6 506 00 6b * Mass.

THOMAS HUGH FERRIS, SR.

MICO RMI AS 6.65.5’. i. 54 ca x baa POY 6 oo «os PME odie ik uleswaunear

ENDORSEMENT

(To be filled in by cemetery or crematory official)

reby certify that the body accompanying this permit was

URAL, | et ga mad ve S tbe _ A , |

(Name of cemetery or,crematary)

(City or town)

eote eee rene

| If there is no officer in charge, undertaker should sign and return this stub.

| |

| : URIAL (OR REMOVAL) PERMIT

R309, 100M-10-80-156788 ' SIO Pw ‘ity : ° eeeeeveeee

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

BF nl ol ectih

a DOMALD.. MORRIS FUNERAL oF feel

eeeeeeesseeeeeeeeeeseeeeeeeteeeeee eee seeeeseseseesseeeeeeseeeeeeeeeeee

\ —— a ie i race KL HL 0 eran + ere he —_— fo MOULTON ROAG ENDORSEMENT Date of death..... w U LN. sh [ Q c | 740 rl ith adlliaiel ella sel 2, (To be filled in by cemetery or crematory official)

ereby certify that the body accompanying this permit was

Cause of death.... Py EK. Mo N. LA rrr Are reer rere sed of in accordance with its terms

f euthborough Rural Cemetery Southborough

Interment at..... RU & A [ Es é (\ x! E TAR

etree eee ee eee ee mores eee ee eee eseeeeseeeesneoe

eeerereeeeeeeeseeeeeseeeeeeeeMeeeeeeseeeeeeee eee &

(Name of cemetery or crematory) (City or town) July. .13,....1990 eee he Zz Bins ats VA Serer “Weer ee | / , f

a Ml 3.2... ae Date permit issued uly Eilat 13,199 iLEdkwcs oahaes Wale fied by 0°77 at eer elbntsd Sere

t™

(Signature of Superintendent, cemetery or crematory)

Certified by p Ae P by ‘ .: | ‘a — e. A Lé} f NEL a Re eet | M.D. If there is no officer in charge, undertaker should sign and return this stub.

9 R309, 100M-10-80-156788 G ate) N q— ZO | No 72 Dye Sn) 0 4 @w 6:6 6s 0 6 60.6 6% » 0 a ,

BURIAL (OR REMOVAL) PERMIT 3URIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

This coupon to be returned immediately, properly endorsed

to nA

(Office issuing permit)

em et te ene * * ene ame so SEs o DOM eM Mme eb ane haa Day os cc x Les

ENDORSEMENT

(To be filled in by cemetery or crematory official)

iereby certify that the body accompanying this permit was ised of in accordance with its terms

uthborough Rural Cemetery, Southborough ,MA

PARES ROS ROS MMOS eee RRR ESTES CMe Moses oe Cee

(Name of cemetery or crematory) (City or town)

| Sees uperintendent {cemetery orcr matory) | [

; Se j f / 4 “a A / i ( ) lee } a af 4 = cosy’ Lf f P 7 ified by ... he Lite. Me AE sWseye X A Maciel - Supte (Signatur of S : If there is no officer in charge, undertaker shoul

sign and return this stub.

R309, 100M-10-80-156788 be 2 Pie CG 6 de ws 00's er eiee oe

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

eoeovcoccoece WET Seeeeeeeevneeoeoeeeeee eeeeneeve

Place of death. .

Date of death....

e ° ee

Certified by db CML ... a Oo ee M.D.

3URIAL (OR REMOVAL) PERMIT

This

D be returned immediately, properly endorsed

to

pr Town of... re TT TE dnc cuw cc ceee Mass

) B Swed e of deceased . hese) Re eee e

EES SO SSE SSS CBS O10 G'S, Bi OLEKE SG O58: Wi BO) wl alle been

ENDORSEMENT

(To be filled in by cemetery or crematory official)

ereby certify that the body accompanying this permit was sed of in accordance with its terms

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80- 156788

eeeeetiovneeeee ees

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Interment at Rural. ; (lon KS sc Do

oeoeoe oP FP e ee eeeereeeeeeeeeseeeeeeneeee

Date permit issued Guguat EYAL LO iellee ihc Certified by RR W i” Rett ad gaserl: Le ee Teas M.D.

on i eva A

BURIAL (OR REMOVAL) PERMIT

This coupon to be returned immediately, properly endorsed

~ issuing permit) Sw ciae R&S

Gity or Town of «2.0... Se Gc cecccecets ccc teesesepereccsescene Mass.

Name of deceased ...... Zh. oncl re bie’ Keech -

If a U. S. War Veteran, specify what war, organization, etc.

fa, Weeld Glee gr I (yep

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

t .. Rural. Cemetery.................... Saeuthhoraugh,MA (Name of cemetery or crematory) (City or town) on itis a Rig. LA... He Hose ia cene wan eetwes eee it~. fi

Certified by

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80- 156788 ee rf y)

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

eeceeoboeceeeeeceehHhesneseeeeeeeeeree ee eevee e ee ee &

MA.

Interment at ..UVEA 4 Ce FINOr? LY. (wR eesreRy re a

Date permit issued .... Slit, Al ‘- hE eee

Carihied by <i... Je ee KR i, 5 rae M.D.

R-309 ony ae

PERMIT

BURIAL (OR REMOVAL)

This coupon to be returned immediately, properly endorsed

ie Jowy C L EK k

(Office issuing permit)

City or Town are Leben hawaii kh + Ree ks so cu 4 es Mass. ‘ 4 " L6H. D GAMWAWE orcs

If a U. S. War Veteran, d¢pecify what war, organization, etc.

Name of deceased .

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was

disposed of in accordance with its terms

Certified by ..... A lid ie Vis Lender 3 ae

(Signature of Superintendent, cemetery o atory)

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Name of Deceased .. C ARLE ‘ Ff P BRLL/IELT- ea ea

Age eee 00 Go ais oheves VEAMS+ seer esse eeeseees months ase a 600 6) & SM Ole S Vie days

Place of Fes ae SIMI. ., f Dy it errerr rere :

Date of death.. Ockeher). / q, PAs 70 Peo. ) Colon

Galil of death MN ETRSTATIC.. CARY MMB 2 a

Y

Cartified by .its.0c Moret: Seren eecuas

R-309

PERMIT

BURIAL (OR REMOVAL)

This coupon to be returned immediately, properly endorsed

to mit)

sus Loa

Name of deceased . mr. cscccccccneseees

If a U. S. War Veteran, specify what war, organization, etc.

eceoeceeeeoeeeoeoee ee eee eee eeeeeeeeeseeeeeeeeeeeeeeseeeeeeeeeeeeeeeeeeeeeeeee eee

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

S's 6 & @ OS 6 6.6 4.0) b) BUNS 6 06-6 08 01a 66 O 66 86 b 06 © Oe See ODF TSS DUS CLUS EG OOOO C6 08 8.18 8 Ore 8 8

Certified by, Cor the Te S pa eee ner ea

(Signature of Superintendent, cemetery or crematory)

”, ee officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

A. Mee 5 ETER. WA Oswork.tilt....

Name of Deceased ...... W/ / — ERE dD EY eh PO AGAR Ny LA WAV d

Date of death....... Nov... [9 if O

eno oP ee eoeoeeeeeeeeeeee eee eeeeeeeeeeee

Cause of death.. Cn RE Ro es VASCU LAS : Atinewt

Interment at....... NV Ewteo ; Ce Ei" ATE K y ; cheeses eas

Date permit issued ....... [Vp VEM BER... Ad, : Vid 10

a No. . 4 aes LO be i

PERMIT

BURIAL (OR REMOVAL)

This coupon to be returned immediately, properly endorsed

Bd of Health

to (Office issuing permit) City or Town of ...- Southborough eee? oO. ie ony Mass Name of deceased .......... Wilfred. .J....Turenne.,...........

If a U. S. War Veteran, specify what war, organization, etc.

eeeeeeeeerere eee eee eee eee seeeenrzreeoeereereeraeeeeeneeeeeeeeeeeeseeeeeseeeeeeeeee ee ee

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

“RRR Newton.Crematory.,..Newtony-:-MA-----::++::

(Name of cemetery or crematory) (City or town)

BND iV November..20,..

Certified wil %

(Signature of Superintendent, cem

etery or crematory)

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788

ae Koay 5 a

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

viene ob Me Gerny Vous

Age Slalieice ee 5G os VEATS+ seer eevee eeceees months sks. 619.0) 60) Stale 6 0, 8.6 days

Jo WoL DAL Place of death........ Se Y TH Bo XK. } Fld é 4 A ere e |

eeoeeeeetew’eeo ee teeesefercestina Ceo eeeeeeeeeeeeeeeeee eee eeee eee eee

Interment at......4 Ki, S 4 Au . (ein E TER. y, Souris oH

Date permit issued Oi Ae ¢.L a! Bek Cee

Certified by... Th 0.00 y. i a S09. WWE .....MLD.

R-309

BURIAL (OR REMOVAL) PERMIT

This coupon to be returned immediately, properly endorsed

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

at .Rural.Cemetery............ Southkereugh.....MA....

(Name of cemetery or crematory) (City or town)

coe tec ee ee ese eee eee eee eee oe

| ae Certified by aid

(Signat

R309, 100M-10-80-156788 R-309

No. So 7)... > Seti Be ne) PENA

BURIAL (OR REMOVAL) PERMIT _ BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit - This coupon to be returned immediately, properly endorsed

| | j | to Bo FR : Fem Lbelp Issued to db oN, ale . Ne Wena. Fowia I , Neva. ‘ | (Office iseuleonaee it) ‘City or Town of . ©. {tlnbaous h bebddigiacsaas Mass.

VAM Name of deceased LUC LWO / BNW

ceeceecee eee eee ee eeeeee ose eos eeeeseeeesreeseeeeeeeeeeseee

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

(Name of cemetery or crematory) (City or town)

on ..Yanuary..21,..1991.

’ se eeoeeeseeeeeeeeeeeeeeeees PP ES Eik- 8 OO SiR SLRS 8) 8 S18) 0) O16 8 , 4

If there is no officer in charge, undertaker should sign and réturn this stub.

R309, 100M-10-80-156788

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Issued to apo ss

R-309

ti Se oaks oF A

BURIAL (OR REMOVAL) PERMIT

This coupon to be returned immediately, properly endorsed

_ 7 6.60): CLE

(Office issuing permit)

City or Town ) Me ek ee et Pe eae BE ee Mass.

Name of deceased . perp - a. iiaka ig aa heceaen

If a U. S. War Veteran, specify what war, organization, etc.

Certified by: May. errs

pt ae M.D.

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was

disposed of in accordance with its terms

i NRE tala aaatgs mee

(Name of cemetery or crematory) (City or town)

on ..NAnvAaLy..22s. aren fe asa be en a

Certified by... .ééche YA. Xf th hate SB

i (Signature of Superintendent, cemetery or/crematory) uv

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Issued to Doahd 0. Masur Funtal if yh

Place of death...

Dateof death: a Ad Aasg / Alt oe |

R-309

BURIAL (OR REMOVAL) PERMIT —

This coupon to be returned immediately, properly endorsed

| Focted CAs

_ (Office issuing permit)

ERs 3 i's OS «Sc ka Hu 0 bk 6 WHE cat's can Pla De Mass.

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was lisposed of in accordance with its terms

Wepre... Cemetery |)... .ciee seuthberough.,..MA.. (Name of cemetery or crematory) (City or town) ame ebruary Wag 99T, gc. cc SRM top ly TR Certified by .\ 7). Ls, Alii... (Supt) ~~~ “(Signa ho uperintendent, cemete y or crematory)

If there is no officer in charge, undertaker sHould sign and return this stub.

R309, 100M-10-80-156788 . R-309 ek fate | ro theca | Oo

BURIAL (OR REMOVAL) PERMIT = guRIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

on Tele, CR

(Office issuing permit)

ey AMA AM SE City or Townof .-.--- Ruth PE ey eH wees Mass. Name of deceased slew Pe is [Leweend Kee

If a U. S. War Veteran, specify what war, organization, etc.

Seed SS CHORE HESSESCHSHKSSHSSEHC CC HCeoHPHS SSO ROCA HREHEASHECFC HRS HMAHKC EEK HBR HEM HRHeOSeOSCHBEeOH eee

ENDORSEMENT

(To be filled in by cemetery or crematory official)

j / | ( alps I hereby certify that the body accompanying this permit was MO netsh es oa t's s FE EME oe OR oe chan disposed of in accordance with its terms

Cause of death. //.\4< <i - ural. Comelery ie. i......: Southkerough.,...MA.... Interment at Ruta. Comlily se Jf 2 = (Name of si or crematory) yo or town) on .hebruary..22%.42991...... Vier ee ee

Date permit issued Fatwa. ie i OA), ; i 4 q halide

Certified Ral eg Pe ah aa M.D.

of Superintendent, cemet¢ry or crematory)

Certified é Po \ <i Like Le Le V/A /.... (Supte.

| * | | (Signat |

If there is no officer in charge, undertaker Khould sign and return this stub.

R309, 100M-10-80-156788 Ob q| ; ane R-309 No le (eae

BURIAL (OR REMOVAL) PERMIT

| BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

This coupon to be returned immediately, properly endorsed

Sl a a) an

(Office issuing permit)

City or Town of

| ike of deceased Adtaay, . feo. + oR BP ee » |

If a U. S. War Veteran, specify what war, organization, etc.

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

at . Rural. CemeGery............ Southbeorough,....MA....

(Name of cemetery or crematory) (City or town)

Certified by .. SS

| If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788

eeeoeveoeeeeseeseeeeeee

BURIAL (OR REMOVAL). PERMIT

Stub to be retained by officer issuing permit

Certified by Ff. ROO. NSK | pea htd ohp/ |

R-309

No... Y AoW ¥ ae ay

PERMIT

BURIAL (OR REMOVAL)

This coupon to be returned immediately, properly endorsed Ctr

(Office i issuing beisiih ha

City or Town of Mek tt Jot eS COTE th bwr4_gH a Ee a ie 4 Mass.

Name of deceased

to

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

RURAL CEMETERY CREMATORY, WORCESTER, MASS

(Name of cemetery or crematory) (City or town)

ONE Magee BESS ROOM Oa Certified by ..... Unthlune re Ahlude:

(Signature of eee cemeter¥o 7 REET

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788 : R-309 / ING@s see a ¥ The G | 13 INO. -e sic ees 6 5-7 cecceece

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained b officer issuin j y g permit This coupon to be returned immediately, properly endorsed

| : lOunw CLE Rk Issued to --:--:- y, gral, ‘ é. Mone fora «A. ; Mim + igre isu ao

City or Town of ....-.--- A TUL. AO. Wig ee eee Mass. , aa

Name of deceased ...... Hou NA.. i a TARKIC 4 ae Pee

If a U. S. War VeteranY specify what war, organization, etc.

2 eee

ee Al Slimane tel Ow aNeLe S 0.4 0a) MO © OM BOS Oe 6 DKS OS 0 © ChE ws 4S A Oe hole) 6 4 #9 © Gye Lee) O18 6 01m OR EIe 8.9 ©

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

@ apural .Cemebery.......4:.: Southhoraugh,....MA.....

(Name of cemetery or crematory) (City or town)

ified by..... FE ¢.. Jp: kK Roc} | ; | Certified by Ret ies \ cea pies 6 es Ix Ce WS. Ku Peer If there is no officer in charge, undertaker sHould sign andreturn this stub.

R309, 100M-10-80-156788 4 a + N

OQ. eo eeerevreseeeesececen

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

Issued to -:- | - Ba Ynsrtadgaltee ee

are tere Be ol wise s 6 6618 o's months:::>++«4s0++** days

in

R-309

R309, 100M-10-80-156788 cok ' _ rf ee i: q ia AO rf

eoeeeveeceeeee se eeeeeee eeoeeceeeeeBoevnes eee

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

ies Jor Doeld 0. )rabtes Fuanesad wf : ee Dee Wit Fees AIT]. Zenesad Neae ees ere

Name of Deceased . FA nets é.. ; Ware bn awa 6 aah

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

on

If there is no officer in charge, undertaker shéyld sign and refurn this stub.

R309, 100M-10-80-156788 I q/ R-309 No. .4 if

ey eres a)... AL294 epee

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

This coupon to be returned immediately, properly endorsed

Ow C jerk

to

(Office issuing permit)

ENDORSEMENT

(To be filled in by cemetery or crematory official)

Cin d I hereby certify that the body accompanying this permit was Cause of death.... “uve Vb TUT bo sree hed sdaus ea ie disposed of in accordance with its terms (Enroma men )

Yn '

ii es CM EE PEGE oh ee.

Date permit issued ,,.)/ 6 OYUN STEY.IN.. |. \ 1 4 ; | Cae : ad Sto ub (f a Certified by ./. 2z¢taw...lic. ARSC hes AP « rs Mga es 1 ~) \y (Signature of Superintendent, cemetery or crematory) i Certified by D eoee os “Oa seeeeee f-) eee Bie sere M.D. If there is no officer in charge, undertaker should sign and return this stub.

BURIAL) (OR REMOVAL) PERMIT - BURIAL (OR REMOVAL) PERMIT

Stub to be retai j issui j retained by officer issuing permit This coupon to be returned immediately, properly endorsed

ould aes ee ee wo Leste, (her _

(Office issuing permit)

MCh ”, i / ; City or Town of OWN. : OF ‘ SOUTHBOROUGE., Name of Deceased . 4 NST WiTTIT oe wee eee eB An ee Oe Sd tela’ .; at eee a Qa a H- EU 2 6-7

yee | If a U. S. War Veteran, specify what war, organization, etc. Age ou Tse ch cuemaae VOATS- eee e eee cececceees months :-->----eeeeees days lilt er Jil

ENDORSEMENT

Date of death... 4. UALYUA UH” antes aed ee » il (To be filled in by cemetery or crematory official)

feat &. I hereby certify that the body accompanying this permit was SPIE Fe Rite PEM os Poms a Vitae tek Ah eA oe disposed of in accordance with its terms - 3 {po ative Rural. Co@erenry......... Southkoreugh.s...MA.... re I ket ok eae (Name of cemetery or crematory) (City or town) Pe Ws VANUALY . Bite. AAPA vavsnessh ees forriffrrerrrrccen

If there is no officer in charge, undertaker should sign and return this stub.

R-309 Na. fe ATA Lee Raw

R309, 100M-10-80-156788 a No. . Zr — Ve. arose ecwrele

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

] to | Issued to - Denekd. (}. g's pee ‘ Kynthal. es (Office issuing permit)

ENDORSEMENT

Date of death... . 02 . f . / eoeeeeeveeveeveeeeveeeeeeeeeeeeveeeeeeeeeee ° (To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was

Cause of seu earpasitcer. Pisin en “h of in we’ with its terms

Interment at Kil ok Comitery - zer wth ely ut hhc si “es pai Sait io fh apa mere ae ou PO oe 7) ae a

ry or crematory)

(Signature of Superihtendent, cem

Certified by. KD, PT Oe @ Py dh i TE ils awe cab 6ou M.D. If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788 3 rd q an

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

f

Name of Deceased . ow! € Cie BERT Coma ‘fv

Age eeeoeeeeee rs . — ° years eeoeveeeeeveeeeeeeee months eeer,eeveeeveeeer days PFOWN OF. SOLITURGOROILICH Place of death..\.. » VI ses Q. ee A) i “Rok TBL IR apts | GeO te

. a

c f

Cause of death... hy EK TAS. TATIC (ay tex OF TIE. byery

Interment at........ Fo KR B. ES. (’ P,)- 30 -9,) See

Date permit issued

Certified by........

R-309 3 3 9 2

BURIAL (OR REMOVAL) PERMIT

This coupon to be returned immediately, properly endorsed

to Teun Chak

(Office issuing permit)

ity or Town of » AWN OF SOUTHBOROUGH

eeoeoeoereeveeeeeeeFCeeeevre Tees eo eseoseeseeseesevneseaosteeense

ast of deceased ..... He je > CieneK +t Comal. cs

a U. S. War Veteran, specify what war, organization, etc.

PPE UaTLGUEs VeeDy kant) HOE) MPa AEN a9 CU

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was sposed of in accordance with its terms / 7Z :

Farber

(Name of cemetery or crematory)

ewe ec eeer eee ee eo,;eeeoeeeeeeeeeeeeeeeeed

(Signature of Superintendent, cemetery or crematory)

If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788 Yu“ — Gg *

BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

” - Qeashh lh. We CF ee) a mane eaptsy hh ge att. rf),

Name of Deceased AONE... MUR IEA FAD ooh...

Interment at ../7, + Odipet Camede we Y eee

Certified by. (AY oer aE Reon M.D.

R309, 100M-10-80-156788 —_ y, 24

BURIAL (OR/ REMOVAL) {| PERMIT

Stub to be retained by officer issuing permit

Date permit issued

A RUTILIORS TAP Wo cd gg Cass Ai Beare eee ue oa ae EL ease os ed coe eee

309 P No. « S-LA aneee

J le

(OR REMOVAL) PERMIT

BURIAL

This coupon to be returned immediately, properly endorsed

. Mer OWA. TOLER ke

(Office issuing permit)

me of deceased .

eeoeneeveeeeeeeeeeeeeeeeeeoee He

a U. S. War Veteran, specify what war, organization, etc.

rere y terete eee cee ee ae ee ee ee ee ee Oe ee Se Oe ee ee el

ENDORSEMENT

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was sposed of in accordance with its terms

R309, 100M-10-80-156788 wee G2 R-309 a “9 ‘

No. «Bal « os aes « Ca ce & IND) soe Gats aac wa cndraicit

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit This coupon to be returned immediately, properly endorsed

to . owt e eee )N GLE

(Office issuing permit)

Cidy Gy Velnlor(.) ft. 5 SOL % HBORO! IGH Bess wie Mass.

Name of deceased .:

*eeowvwverereeeeeeeeeeeseeeeeeeeeeeeeeeeeeeereeeeeesee ere seeeeeseeeeeeeeeeeeeeeeeeee

ENDORSEMENT

Date of death...... “yeu. (To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

at «-... Rural, Cemetery............ Southborough», MA, (Name of cemetery or crematory) (City or town)

on .. AUgUSE. Ake. ee CPE EE Tey) 2 Sameer ya phe Seed tees

( Sswhaee of §) perintendent, cemetery or verdana

Carttileall Beat sis ilies pureed: ki eel adie sex didinbvasauectenad M.D. If there is no officer in charge, undertaker should sign and return this styb.

R309, 100M-10-80-156788 | J- “4 R-309 Vow f me INO. obs s6s 3% ses ta wee INDY « Fes eee ef ae oe

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained by officer issuing permit

This coupon to be returned immediately, properly endorsed

t OWN CLEBN

(Office issuing permit)

chf Mh, AE SOU

Pa 2 FS PS MOS OC AHR SS O'S OBS 0:6. 8) S58) C2) © 8 OORT OBO BAS GS O06 6 CW Oe CIES bw & 6) © Gnd ee iere bee eres oe: 6 6 &

ENDORSEMENT

(To be fiiled in by cemetery or crematory official)

Metacts tie Colon I hereby certify that the body accompanying this permit was Cause of death

atin tevic eh Seb Wha ab aled nea ed od cove va baateaelee cea eee disposed of in accordance with its terms

RURAL CEM&PERY CREMATORY, WORCESTER, MASS.

PASS SS PASS HSE RS Oe OA We O Eee 6 Oh OS O58. s RL Si els 6 6 te 6 Oe 6 6 Se eee

Date permit issued Ot..4 9G os saneiibiiee ae , P ‘ f r Certified by eeee . é; ° ee oteog ° oe ree “By eeoeeeeeevesn | (Signature of Superintendent, cemetery or crematory) Certified by thee! K af LR oe oe er M.D. | If there is no officer in charge, undertaker should sign and return this stub.

R309, 100M-10-80-156788 gy 9 s | ' R-309 y 9 2 . No

BURIAL (OR REMOVAL) PERMIT BURIAL (OR REMOVAL) PERMIT

Stub to be retained by offi issui j y officer issuing permit This coupon to be returned immediately, properly endorsed / : ee a [or N CLER is rt.) Make > UL m C (Office issuing permit)

LOWD.AE. SOUTHBOROUGH... Mass.

ay | Plemmie of deceased «1.6.08 he Facer c cc cccnslenccsceceressnsccccess GO — seers | If a U. S. War Veteran, specify what war, organization, etc. Age Sie leLeie fi ciels) sthia mistene VCATSe ee eeeeevees months d eeoeeoee PFIOMTITMS eee > ee eevee ecvee ays f-O

Stoel od obs Ee SW SVS ELS Sp OES © ©. 9G) SG SS SSB: SS Mia yO SS 6 (0 10'S) 0) SO 5RNE 6 SSO © 6S MOOS 8 Oe BO GS Oe 2 eS

Place of deatif. OWN..OF.- SOUTHBOROUGH...

b> ) ; ENDORSEMENT Date of death...*... A Se tet’ Ch eee Are

Cause of death ‘nila

(To be filled in by cemetery or crematory official)

I hereby certify that the body accompanying this permit was disposed of in accordance with its terms

re ow .RUral.Cemetery............. South