This permit must accompany remains to destination

Bureau of Vital Statistics                      Wisconsin State Board of Health

BURIAL --- TRANSIT PERMIT

Full Name of Deceased:  Emil Reineke

Place of Death  Eau Claire   Eau Claire Co., Wis.

Date of Death  June 10, 1948,   White,  Male,  71

Cause of Death 

(Completion is not necessary for Wisconsin burial)

Burial, Cremation, Removal

Burial

Cemetery/Crematory

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.

R. V. Izydorek, Thorp, Wis.

To dispose of said deceased as above stated.

                                             Signature  Carol M. C-----?, Deputy

Date  June 10, 1948             Address  Eau Claire

Cemetery or Crematory Authority Shall Fill Out Space Below

Body was  buried                  on   1948                  in  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.