Harold Orrin hurdGreenwood Memorial Park 2300 WEST VAN BUREN STREET
PHOENIX, ARIZONA:: 85009
TELEPHONE 254-8491
F.H. Best Funeral Servic
Cremated Remai
HAROLD ORRIP
AGE 75
of
HURD
3368
DOB: DOD: May 18, 1990
Cremated On The 21st Day Of May 19-90
GMP 106 _19
t 1;-4., STATE OF ARIZONA REGISTRAR'S
�f11hi :'1:tr.:aui=.;ea:-,ts'y DEPARTMENT OF HEALTH SERVICES- OFFICE OF VITAL RECORDS FILE NO.
Lod)/ w, `"�''�' '"�`"a�'�"� DISPOSAL - TRANSIT PERMIT 2317
VS -7 PF\/ R/88 CEMETERY MGR.: MAIL TRANSIT COPY IN 10 DAYS TO VITAL RECORDS, P.O. BOX 3887 �e
DEPARTMENT OF HEALTH SERVICES, PHOENIX, ARIZONA 85030 41
NAME OF A. FIRST B. MIDDLE C. LAST
SEX
AGE
RACE OR COLOR
DECEASED
Harold Orrin Hurd
Male
White
IDENTIFICATION
I
z.
3.75
,.
DATE OF DEATHPLACE
OF DEATH A. TOWN OR CITY UNTY .. S✓" TATE
OF
5. Ma 18, 1990 B.
Peoria Maric�a Arizona
DECEASED
CAUSE OF (MUST BE COMPLETED IF BODY 15 SHIPPED OUT OF STATE, MOVED BY COMMERCIAL CARRIER. OR A DEATH FROM CERTAIN DISEASES)
DEATH
7.
r] BURIAL � OTHER
FUNERAL HOME A. NAME B. ST. ADDRESS C. CITY AND STATE
MANNER
(SPECIFY)
Funeral Services 9380 W. Peoria Av. Peoria, Arizona
CREMATION a.Be�.�t
AND
Courtesy
FUNERAL DIREC OR SIG TU E
DATE SIGNED
REMOVAL
1,,.8/7/90
PLACE OF
B Permit 14
r
DISPOSITION
PLACE OF BURIAL OR NAME 0. STREET ADDRESS C. CITY AND STATE
OTHER DISPOSITION
12, Blair Cemetery Blair, Nebraska
13. IN ACCORDANCE WITH THE LAWS OF THIS STATE AND THE REGULATIONS OF THE STATE DEPARTMENT OF HEALTH PERTAINING TO DEATH CERTIFICATES
REGISTRARS
A E HANDLING OF DEAD HUMAN REMAINS, AUTHORIZATION IS HEREBY GIVEN TO DISP05E OF THIS BODY IN THE MANNER INDICATED.
AUTHORIZATION
R�'S SI GfJATURE
DISTRICT
DATE SIGNED
FORcDISPOSITION
���R'F_G.
L �`
ie.
Y WAS
EME ERY OR A. NAME B. STREET ADDRESS C. CITY AND STATE
DISPOSITION
BURIED
CREMATORY
NE
IB. Blair CemeteryBlair
OF BODY
CREMATED
DATE OF DISPOSITION
SIGN URE
tSPECIFY)
OTHER
/ (J
ICEMETERY^ANAGER,'S
,�3.
/l/
17,
19.
20.L%��
DATE R N ATE OFFICE
REGISTRARS SIGNATURE Td-T1E
STATE
REGISTRAR USE
122
21
22 A B
VS -7 PF\/ R/88 CEMETERY MGR.: MAIL TRANSIT COPY IN 10 DAYS TO VITAL RECORDS, P.O. BOX 3887 �e
DEPARTMENT OF HEALTH SERVICES, PHOENIX, ARIZONA 85030 41