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:  Edmond Morrison

Place of Death  Twn Hendren R#1 Willard, Clark,  Wis.

Date of Death  Frb 1, 1979               White          M              55

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, Wisconsin

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.

Don Izydorek, Thorp,Wis.

To dispose of said deceased as above stated.

                                             Signature  Dennis W. Melgin

Date Feb 2, 1979                Address  Thorp, Wisconsin

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was   buried        on Feb 3, 1979      in  Butlerville

Located at  Town of Thorp              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.