Burial PermitSTATE OF MINNESOTA
DEPARTMENT OF HEALTH Burial - Removal -Transit Permit
Section of Vital Statistics
,to_& -� 4.1 -
Permit No- 661
NAME OF DECHABED DATE OF DEATH DEATH CON39MIC-ABLET
William Harold Bitting Oct. 9 1971 ❑ Ta 0 No
S= AGE PLACE OF DEATH (®(VIWFo erjDalpmt (COMBO)
Male 73 years I Excelsior H ennep n
METHOD OF DISPOSAL: PLACE Or DISPOSITION (NOVO st ewetu, r rea- W") (CIO, VD1Ose a Tow=Mp. CosnO. State)
® BURIAL ❑ CREMATION
REMOVAL ❑ OTHER (.near» Chanhassen Cemetery Carver Minna
EIGbIA F MORT'ICLN O FUNERAL DIRECTOR BUSINESS ADDRESS
T, 520-2id. St. Excelsior Minn.
A aetlOets of Jath ba tag bsMB vied u ngnhvd b, law, we labs in henbl fff w bo dbnae of thb body.
SIGN4"/6F REGISTRAR Z (CIO, VMMO or TO.~ (COMBO) DATE ISSUED
Excelsior Hennepin I Oct. 13 1971
S1GNA OF PERSON IN CHARGE OF CONVSVANCE
AUTHORIZED DISPOSITION AS STATEDI A� SIGNATUF,d Ol 861'H)N
ABOVE OCCURRED ON: (Dabs)