Louis R MurdochMONTANA DEPARTMENT OF
HEALTH AND ENVIRONMENTAL SCIENCES
Vital Records and Statistics Bureau
Cogswell Building, 1400 Broadway, Helena, MT 59620-0901
AUTHORIZATION
FOR REMOVAL, TRANSPORTATION AND FINAL DISPOSITION OF A DEAD BODY
ORIGINAL TO ❑ ONE COPY TO ❑ ONE COPY TO MORTUARY/PERSON i ❑ ONE COPY. TO CEMETERY/CREMATORY
Local Registrar Coroner IN CHARGE OF DISPOSITION OR TO ACCOMPANY REMAINS OUT -0F STATE
Machine or Facsimile copies of this form shall be valid for all purposes
of fetal death, check this boss 0 and pro" data for mothw cc#etus w aWopriate
NAME: LOUIS R. 14URDOCH - DATE OF BIRTH: ? F 11 , 19Ct6
SOCIAL SECURITY NUMBER: 506-03-5949 Male 171 Female
DIED (or was found) ON: JULY 5 1995 2:30 AM
date and time
AT:
BOZEMAN DEACONESS HOSPITAL
name of institution, address, location of death or discovery as best described, including city or town
IN
GALLATIN COUNTY.
JULY 5, 1995 BLAIR CEME'IERY U buried/ U cr
date of disposition
BLAIR
city of disposition
cemetery or crematory name
WASHINGTON NE
county state
sexton or person in
zip