Interment Record2 RECORD OF INTERMENTS
Made in_a,.e e t ---------- Cemetery,:"J___._.of..5,%Cil eucr i_,,
r --L__________County, .Minnesota.
Kept by the person in charge of the premises. Under Chapter 454, General Laws 1907.
FAME OF DECEASED PLACE OF DEATH
DATE OF BURIAL -
Munth Day Seer
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RECORD OF INTERMENTS 3
Matte in. ---.-.of _ 'C'L --------
c -Country, .Minnesota.
Kept by the person in charge of the premises. Under Chapter 454, General Laws 1907.
NAME AND ADDRE6S OF
DATE OF BURIAL '
AMR AND AD OF
EDI ISA LMP:R OR CNDF.RTAKRR N.\MF. OF 11F.CF.A6F.11 I'LA('F. OF DEATH
Month Day Year EMBALMER Olt UNDERTAKER
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RECORD OF INTERMENTS 3
Matte in. ---.-.of _ 'C'L --------
c -Country, .Minnesota.
Kept by the person in charge of the premises. Under Chapter 454, General Laws 1907.
NAME AND ADDRE6S OF
DATE OF BURIAL '
AMR AND AD OF
EDI ISA LMP:R OR CNDF.RTAKRR N.\MF. OF 11F.CF.A6F.11 I'LA('F. OF DEATH
Month Day Year EMBALMER Olt UNDERTAKER
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