Dale L KnightBlair, Nebr. Cemetery
x
Omaha, Nebraska
Permit for Interment
Complete the Following
Number
Name of Deceased Dale L. Knight
Date of Birth
Aug 7. 1935 Age 51
Home Address
7087 Spencer St.
Place of Death
Omaha
Single, Married or Widowed married
Race White
Cause of Death
pending
Date of Death
July 22, 1987
Date of Interment
Nearest Relative
Maralyn K. Knight (wife)
In Whose Lot Interred
Lot
Vault
own lot
Section Grave
Box Tent
Relation to Lot Owner
SIGNATURE OF FUNERAL DIRECTOR
I hereby authonze the interment of
in the lot and grave space designated above.
Signature of Relative or
Legal Representative
1z