Burial PermitMINNESOTA DEPARTMENT OF HEALTH `� r
Division of Vital Statistics
Registrar's No.
Permit for Burial or Removal
A death certificate as required by Minnesota Statutes 1945, Section 144.181,
having been filed in my office, permission is hereby granted for the disposition
as indicated below of the remains of:
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AGE
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PLACE OF DE TS DATE OF DEATH
I BIRTHPLACE
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This form may be used for disinterment -reinterment in accordance with Regulation 43.
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