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Name.
Unit
Block
Lot
Date of Mark-out—� 0
Date of Burial L) Time—
Name of Funeral Home
Authorized by
Fischer, Raymond A. & Marie E. DEED #443
Box 247, Brevard Avenue
Roseland, Florida 32957 12A,
Unit 2 addition, Block 47, Lots 9 and 10
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Paid by "20'elpt No. ....23.8..... .... Dated .... March • 2.4;• •1.9 &l
List Price $. *.*21)0...00 to - .
Discount $......... r. 0.7
Net Paid $. **.200.00
Maximum No. Burial spaces ......2.....
Total area In square feet ... ==== .......
Monument permitted .... f1 a t
J
DEED #443
Fischer, Raymond A. &
Marie E.
Box 247,Brevard Avenue
Roseland, Florida 3295:
Unit 2 addn., Block 47
Rules and Regulations attached (Data above this line for City Record only) Lots 9 and 10
Proprietors of the Pittsfield Cemetery
203 Wahconah Street
Pittsfield, MA 01201
CREMATION CERTIFICATE
General Laws, Chap. 114, Sec. 48
The undersigned, being on this date the person having charge of the Crematory at Pittsfield Cemetery, hereby certifies that the Burial Permit and Certificate of
the Medical Examiner prerequisite to the cremation of the body
of .......... Marie . . .... E... Fischer ........................... late of ........Pittsfield, MA ................................. who died .....July 1., 2000
............. .
DATE
at Pittsfield, MA ..... have been duly presented.
................................................................................................................................................................................ ...............................
CITY STATE
Con estive Heart Failure
Causeof death ...................... �...................................................................................................................................................................................................................
Age .... 93 ..... years .....l�..months ........ .2........... days. Crema n No.......%3 -. .......... .. .........
Date............ J . u. 1y... �. s.... 2. QQQ ... ............................... ...... .....�... ii ' .....................
Super to e t
This certificate should accompany these remains to their destination.
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