Burial PermitFORM HI I..
Department of Public Welfare---Division of
Public Health
Office of the Local Registrar Vitai Statistics
MINNEAPOLIS, MINNESOTA
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CITY HALL
4/21/1942
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A Certificate as Required by law Having Ben Filed, Permission i, Hereby Granted for the Proper D'upeition
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John Wey SEX ..r l-e
NAME Peter John
AGE 71
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PLACE OF DEATH Rest Home
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DATE OF DEATH 4/19/1942 NATIVITY ;thane SOC. ST. Widowed
CAUSE OF DEATH Cerebral arteriosclerosis
MED. ATTENDANT F. J. $ucera
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DISPOSITION Chan)isssen Cam., Chanhassen, Minn. DATE
4/22/1942
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FUNERAL DIR. Moore Funeral Home NO. ADDRESS
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PERMIT
"° 5118 COMMISSIONER OF HEALTH AND
LOCAL REGISTRAR
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