Isabel CollingsVITAL :RECORDS SECTION
IOWA DEPARTMENT OF PUBLIC HEALTH I
R'IAL-TRANSIT PERMIT
Full Name of Deceased--------Isabel---------Collings ------------------------------------------------------------------
on
Place of Death______________Ls------------- ---Burt --------- -- Nebraska -_ ________
(Town or City) (County) (State) ---------
Date of Death ---
December _ 2 ________________y 100 Color_ Willie __- Sex --_Female Age --A3 --
__________________
Cause of Death------- Non-conrmnicable------------------------------------------
-- -------------
Cremation Siouxland Crema-
Method of Disposal-------------------------------------------------------------------------------o
�---
(Burial, Cremation, Transportation, etc.) (Cemetery or Crematory)
Town--- Sioux City---------------- County--- Woodbury ----------------- State---IOWA------------
A Certificate of death having been filed as required by laws of this state, permission is hereby given to
Funeral Director:
Munderlo_h Funeral Hcxne----------------- Address ----------------------------------------------_.
Pender, Nebraskffan'68047 ,§
to dispose of body of said deceased as above stated. �� r� ➢
Signature ---------------------------------------
�egistra3`)
Date --- December -4-------------- 19--9Q Address--------------£r3i------------
a Tow NL��jr-,�
ao®� Or ' ounf) [aeuse
CEMETERY OR CREMATORY AUTHORITY SHALL FIL , 1t4 w
mi
Body was__CreMc!tQd------------- on__DeO r 3______----_, 199Q-, in--SiQ>a_x_i_a-zad Cre�ia-tQry
(Whether Cremated, Buried, Etc.) (Cemetery or Crematory)
Located at_84571Qth1S1oux_Cit , Ia _ Signature -------------------- - -'1-11---------------------
SEE OTHER SIDE to
(Sexn or Perso In Charge)
This permit must be endorsed by the sexton (or by the Funeral Director where there_ is no sexton) and
returned to the registrar within 10 days.
588-0002 4/89