Loading...
Burial PermitPLAC OF DEATHL'Or 44.1 STATE OF MINNESOTA ��..... REGISTRAR'S Township... ................................. Ao............ ..I�.......... VilleoR...- - Win..--- - Permit for Burial or Removal city............................................... Date of De th. ....../4.....1923... Full N e. .......... e..........7/.........yrs. Sea...... Place of B' Disease causing death%wQLsJ. i .- ..... ' ..... ....... Medical l �I�11 Proposed date ofl/J�� � attendant f.A rf ...� ......... 4beri�ar removal Place of Burial......a�R.,.. .... . Place of removal... l�sa.. ......via. ... .. ................. Undertaker.. ' . .. .. . .........Address........., A certificate of death having been filed in office in accordance with the laws of Minnesota, I hereby authorize the...................l.,t[,2r.,,�—�1........................of the body fBun�al o_r 1Fornovalh of said deceased person as stated above. In case of death from a dangerous communicable disease, the burial or removal roust conduct ac - g to the rules of the State and (oral board of health. ... _.... sgr o the) ... ................... .. ResTtas .. Dated.... l�./....19 /1��YvaaQp/�� Official Title 'write "Burial" or "Removd" u the er may, be. Burial permits mast be delivered by the Under. taker to the Sexton. Removal =ts must 6e given to the Agent of Tmo rtsbon Company, and attached by him to bcontaining body. Subregistrarn will write "Sub" before the words "Registrar of Ikaths,, and "Lioa censed Embalmer Ho......... ..............." below, always giving No. of Liceo e. Pim or imprisonment for receiving a body for burial without permit. Received........................ 19................................................ Sexton Name of Cemetery..................................Address.............................. 8411-f]-S1-1M NOTICE TO UNDERTAKERS This blank constitutes a Registrars "Burial Permit" or "Removal Permit" according to the manner in which it is filled out by the Registrar. As a Registrar's Burial Permit, this blank must be obtained by the undertaker before any d�spos� . is made of the body. It is the duty of the undertaker to have a certificate of death properly filled out with the personal and statistical facts required by law, to present it to the attending physician for his certificate as to cause of death, and then to file the complete certificate of death with the Registrar of the district where the death occurred. It is illegal to bury a body in this state unless it is accompanied by a regular Burial or Removal Permit. As a Registrar's Removal Permit, this blank must be obtained from the Registrar, as stated above, presented by the undertaker to the Agent of the Transportation Com- pany, and be attached by the latter to the boa containing the body. The Removal Permit is not a Transit Permit. The latter, supplied to embalmers by the State Board of Health, provides for a statement of the proper preparation of the body for transportation, signed by}' the Health Officer. This Transportation Permit also contains a Removal Permit. No Transit Permit can be issued by any Health Officer, or, accepted by the Agent of any Trarspor"ou�ewpuny irr-i linne�ela-nnicge a -Rees Removal- Permit forms part- of it, or has previously been issued by the registrar of deaths. ISSUE OF PERMITS BY SUB -REGISTRARS A licensed embalmer, holding an unrevoked certificate of authority from the State Board of Health to act as a sub -registrar of deaths, bas the right to issue this permit to himself for burial or removal, under the same restrictions as those governing its issue by the local registrar, except in cities and villages which have a local ordinance requiring that all burial permits and removal permits be issued by the local registrar. The certificate of death, fully made out in ink, and signed by informant and physician, most be in sub- registrar'sposs�non before he issues the burial or removal permit, and the death certifi- cate must be delivued by the sub -registrar within five days to the local registrar of the district where the death occurred. The local registrar in a city is the health officer; in a village, the recorder; in a township, the town clerk.