This permit must accompany remains to destination

Bureau of Vital Statistics               Wisconsin State Board of Health and Social Services

BURIAL --- TRANSIT PERMIT

Full Name of Deceased:  Arthur Edmund Reineke

Place of Death  Stanley, Chippewa, Wis.

Date of Death Jan 24, 1979       White     Male     69

Cause of Death 

(Completion is not necessary for Wisconsin burial)

Burial, Cremation, Removal

Burial

Cemetery/Crematory

Butlerville

Location (City, town or country)    (State)

Thorp, WIS. 54771

A certificate of death having been filed as required by the laws of this state, permission is hereby given to Funeral Director or person acting as such.

Bill Plombon, Stanley, Wis.

To dispose of said deceased as above stated.

                                             Signature  R. J. Mathwig, M. D.

Date Feb 1, 1979                Address  Stanley, Chippewa

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was                                  on                         in 

Located at                                     Signature 

(Sexton or Person in Charge)

This permit must be endorsed by the sexton (or by the Funeral Director where is no sexton) and permanently retained in the Sexton’s files.

This permit must accompany remains to destination

Bureau of Vital Statistics               Wisconsin State Board of Health and Social Services

BURIAL --- TRANSIT PERMIT

Full Name of Deceased:  Arthur Edmund Reineke

Place of Death  Stanley, Chippewa, Wis.

Date of Death Jan 24, 1979               White                 Male     69

Cause of Death 

(Completion is not necessary for Wisconsin burial)

Burial, Cremation, Removal

Burial

Cemetery/Crematory

Butlerville

Location (City, town or country)    (State)

R #3 Thorp, Wis. 54771

A certificate of death having been filed as required by the laws of this state, permission is hereby given to Funeral Director or person acting as such.

Bill Plombon, Stanley, Wis. 54768

To dispose of said deceased as above stated.

                                             Signature  Dennis W. Melvin

Date  January 27, 1979        Address 

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was  buried     on Jan 27, 1979      in  Butler

Located at  Town of Butler            Signature  Arthur Morrison

(Sexton or Person in Charge)

This permit must be endorsed by the sexton (or by the Funeral Director where is no sexton) and permanently retained in the Sexton’s files.