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HomeMy WebLinkAbout3-71-09Name�'L Unit Block Lot Date of Mark -out ✓ ,7 Date of Burial /fZ_ Name of Furneral Home��f Authorized by BURIAL TRANSIT PERMIT TRACKING NUMBER: 1.DECEDENT INFORMATION Name of Deceased Date of Death Place of Death - County City, Town or Location Name of facility, or street address if not a facility Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No./Reg. No.Phone Number Funeral Director/Direct Disposer Fla. Lic. No./Reg. No. BURIAL - TRANSIT PERMIT2. The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: State Registrar Date Issued: AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION3. Authorization given by Medical Examiner District Approval Number: CEMETERY OR CREMATORY4. Place of Disposition: Method of Disposition:Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. DH 326E, 10/12 2025227578 JOHN SENAN MORRISSEY December 15, 2025 INDIAN RIVER SEBASTIAN STRUNK FUNERAL HOME- SEBASTIAN F041870 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 (772) 589-1000 SANDRA ASSUNTA MASTRANDO F764131 SEBASTIAN CEMETERY BURIAL 2025-F041870-5172 64V-1.011, Florida Administrative Code State of Florida, Department of Health, Bureau of Vital Statistics PELICAN LANDING ASSISTED LIVING AND MEMORY CARE DATE PRINTED:December 17, 2025 F041870 December 17, 2025 If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. Staff at the certifying physician's office, was contacted on 12/17/2025 by the funeral director listed above; he/she indicated that MICHAEL ANTHONY VENAZIO, certifying physician, will complete and sign the medical certification of cause of death within 72 hours. Medical Verification Statement