Arlene Joyce ChristensonOmaha, -r
Permit for Interment
Complete the Following
Number
Name of Deceased Arlene Joyce Christensen
Date of Birth April 23, 1928 Age 66
Home Address 9738 North 60th St., Omaha Neb . 68152
Place of Death Omaha
Single, Married or Widowed married
Race White
Cause of Death pending
Date of Death Dec. 18, 1994
Date of Interment Dec. 20, 1994
Nearest Relative Rirhard M Christensen— (husband)
In Whose Lot Interred
Lot Section Grave
Vault }fig BoxV aV ate— Tent no
Relation to Lot Owner
SIGNATURE OF FUNERAL DIRECTOR Roeder Mortuary
I hereby authorize the interment of
in the lot and grave space designated above.
Signature of Relative or
Legal Representative
M