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:  Frank A. Winterer

Place of Death  Town of Butler, Clark, Wis.

Date of Death  August 14, 1940            White           Male          71

Cause of Death 

(Completion is not necessary for Wisconsin burial)

Burial, Cremation, Removal

Burial

Cemetery/Crematory

Butlerville

Location (City, town or country)    (State)

Clark, 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.

John G. Bogumill, Thorp, Wisconsin

To dispose of said deceased as above stated.

                                             Signature  D. D. Scootay (?)

Date  August 17, 1940         Address  Thorp, Clark

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was  buried     on Aug 17, 1940   in  Butlerville Cemetery

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.