\ded of the import ar 
jf the Mortuary Sto 
Remarks .. 
- I certify that I attended the person above named, who died of the disease stated, 
on tho date named. 
(Address) 
Place of Burial . 
.. M. D. 
EHSdVd NNVWH39N3 39H03* 
Mdavs iTOiNWoa tanossi* 
