ORIGINAL                                   STATE OF ILLINOIS           PERMIT NO.  1193

PERMIT FOR DISPOSITION OF DEAD HUMAN BODY

FULL NAME                                                                                                    U.S. War

OF DECEDENT     Jessie B. Mc Mahon            AGE:  73      SEX:  Female   VETERAN:  No

PLACE OF

DEATH:    West Suburban Hospital, Oak Park, ILL, COUNTY OF  Cook

DATE OF                       CAUSE OF

DEATH:  10-30-65          DEATH:  Arterio Sclerotic Heart Disease

___________________________________________________________________________________

THE REQUIREMENTS OF ILLINOIS LAW HAVING BEEN MET, THIS PERMIT TO DISPOSE OF A DEAD HUMAN BODY IS ISSUED TO:

Thomas B. Ahern                                    FUNERAL DIRECTOR;   ILL. LICENSE NO.  6346

ADDRESS:  1110 Madison St., Oak Park, Illinois

METHOD OF DISOSITION:                     PLACE OF DISPOSITION (Name and Location of Cemetery)

Burial                                                           Butler, Thorp-Clark County, Wisconsin

DATE:  11-1-65                          SIGNED:  Herbert Ratner, M. D.   LOCAL REGISTRAR

REGISTRATION

DISTRICT NO:  16.24                ADDRESS:  Oak Park, Illinois

___________________________________________________________________________________

SEXTON’S ENDORSEMENT:

THE BODY ACCOMPANYING THIS PERMIT WAS RECEIVED AND WAS CREMATED  INTERRED.

ON Nov 3, 1965 IN Butler Cemetery

LOCATED AT:  Town of Butler.               (SIGNED)  Arthur Morrison

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