State of Minnesota Department of Health

Section of Vital Statistics Registration

BURIAL-REMOVAL-TRANSIT PERMIT

Full Name of Deceased:  Idell L. Brenna

Place of Death  717 18 ½ Ave. N.E., Minneapolis   Hennepin

Date of Death  February 20, 1976            Female           70

Cause of Death 

(Completion is not necessary for Wisconsin burial)

Burial, Cremation, Removal

Cemetery/Crematory

Butler

Location (City, town or country)    (State)

Butlerville Twp. Clark, Wis.

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.

Gearhart-Buchinger Funeral Home, 2535 Central Ave., N.E.

Minneapolis, Minnesota

To dispose of said deceased as above stated.

                                             Signature  Donald R. Oenhart (?) Jr.

Date  2/24/76                       Address  Minneapolis, Hennepin

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was                                  on 2/24/76                        in 

Located at                                     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.