HomeMy WebLinkAbout2-42-02Watson, Carolyn A. Deed # 428
406 Banyon Street
Sebastian
Block 42 -A, Lot 2, Unit 2 Addition
Furman 0. Watson interred 111181
1/27/81
A check has been received and deposited for $20.00 to cover the
cost of the concrete base for the headstone for this grave.
Cemetery 219
Paid by CIAU Receipt No . ............. .... Dated.... DeC . 30, 1 980 , . , .. .
List Price $.., *i4,100.00 **
Discount $.........-- .......
Net Paid $ ..* *100.00 **
................
Maximum No. Burial spaces 1
Total area in square feet ................
Monument permitted . , , . Fla t
s
Carolyn A. Watson
406 Banyon Street
Sebastian
Furman interred 1 / 1/t
Blk 42 -A, lot 2, Unit:
R & R Attached (Data above this line for City Record only)
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
VITAL STATISTICS
&PLICATION FOR BURIAL -TRAO PERMIT
M
NAME OF First
DECEASED
(Type or print)
Middle Last
DATE Month Day ear
OF
DEATH
PLACE OF DEATH
COUNTY
CITY, TOWN, OR LOCATION
NAME OF
(If not in hospital, give street address)
❑
OTHER(Specify)
HOSPITAL OR
INS
'liver Memorial Hospital
Attending Physiciaxil
(Name of Medical Certifier)
(Address)
Medical Examiners o Guy Ulrich.-M.D.,
2 Breezeway Buildinq..
Vero Beach Florida
Funeral Floyd /Strunk (Name) Home / 2405 14th Avenue., Vero Beach, ddr8s
Home >'f or1 �'a 32960
Check A ❑ A completed certificate of death accompanies this application.
One
Ik)EJ Dr,_ I�1 r1Ch was contacted on__ Dar 30,
He has assured me that this death was from natural causes and that he will complete and sign the medical
certification of cause of death.
C ❑ The attending physician was unavailable or this death comes within the Medical Examiners jurisdiction.
The body was released to me by
on
,19
BURIAL TRANSIT PERMIT Permit
No. 130 -816
Permission is hereby granted to dispose of this body by burial, transportation out of state, storage or cremation. For cremation a
waiting period of 48 hours after death must be observed and the Medical Examiner's approval must also be obtained.
Signature of
RX A five day extension of time for filing the death certificate has been requested and granted.
C
Method of Disposition
BURIAL
❑
CREMATION
❑
STORAGE
❑
OTHER(Specify)
I
Date
Issued
CEMETERY OR CREMATORY
Signature of Sexton 4sex or Per son in Charge
This permit must be endorsed n or person in
within 10 days to the local county health department.
HRS Form 326 (1/77)
Date of —1 �I
Dispositions_ r� _ _1'.
Place of oSca.(1
Disposition —?_�
(or by the funeral director when there is no sexton) and returned