Burial PermitPLAATS
STATE OF MINNESOTA
REGISTRAR'S _
Township_ No.
V oa ���� Permit for Burial or Removal
Data
Fall Name ,LV
Sex_
Disease causing
19 ar o
i•S.
Medical 1 burial or date ofl�
attendant f burial or oval f 193
Place of burl 1
Place of rem T/_-�__ via /
Undertakerw_ L!=-` cress F•_--_�-
A certificate of death having been filed in my office in accordance with the
laws of Minnesota, I hereby authorize the ----. _ of the
(Burial or Removal*)
body of deceased person as stated above.In case death from a danger-
ous communicable disease, the burial or removal m econducted according to
the rules of the State and local of h th.Dea
�
Dated 19�
-_4r _— Title
-Write "Burial" or "Removal" as the crew may be. Buri permits must be delivered by the
Undertaker to the Sexton. Removal permits must he given to the Agent of Transportation Company.
and attached by him to box wntaining body. Sub-reeistrars will write "Sub" before the words
"Registrar of Deaths" and "Licensed E belmer No. ..below. always giving No. of
Lleense. Fine or imprisonment for receiving a body for lurid without permit.
Received 19 Sexton
Name of Cemetery _ Address
1667— -3-26 2M
NOTICE TO
This blank constitutes a Registrar's "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 disposition 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 Trans-
portation Company, 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 Removal Permit No Transit Permit can be issued by any
Health Officer, or accepted by the Agent of any Transportation Company in
Minnesota unless a Registrar's 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, has 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, must be in sub -registrar's possession before he issues
the burial or removal permit, and the death certificate must be delivered 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.