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:  Tim Lee Morrison

Place of Death  Town of Thorp, Clark, Wis.

Date of Death  6-11-1972                White          Male       19

Cause of Death 

(Completion is not necessary for Wisconsin burial)

Burial, Cremation, Removal

Burial

Cemetery/Crematory

Butler

Location (City, town or country)    (State)

Thorp, 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.

Don Izydorek

To dispose of said deceased as above stated.

                                             Signature  Russell Mead

Date  6-14-1972                  Address  Thorp, Wis.

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was  Buried      on  June 14, 1972     in  Butler 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.