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Cemetery
Paid by X'aFMMXRecelpt No. .. 2.89....... .... Dated.... Noumeber..16,--J 9.8L
List Price $..175.00......
Discount $... ..........
Net Paid $. ,175.00
Maximum No. Burial spaces .... I.......
Total area in square feet .*. *. *. *.*. *•* t4 t
Monument permitted . , Fla t.............
R &R issued with Deed (Data above this line for City Record only)
DEED # 478
MARILYN HIGHT(DAUGHTEP FOR)
ARTHUR BOMHARD
67 South Willow Street
Fellsmere, Florida 32948
UNIT 2 ADDN., BLK. 42A, Lot 6
Arthur interred 11 -18 -81
�CEM REEi
Index:RECORD # NEWCEM Record:1891
Last Name
Address 1
Address 2
City
Deed #
Unit #
Lot Number
Lot Number
Lot Number
Lot Number
Comment
Comment
<F >wrd <
City of Sebastian, FL - Cemetery Lots
Bomhard First Name Arthur
State
478 Date Amount
2 -A Block # 42
6 Interred Arthur Bomhard
Interred
Interred
Interred
See Marilyn hight
ck <E >dit <D >elete <N >ext <P >rev <R>
Zip
$175
Dte Interred 11 -18 -81
Dte Interred
Dte Interred
Dte Interred
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DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
VITAL STATISTICS
OPPLICATION FOR BURIAL -TRA•T PERMIT
1
NAME OF First
Middle
Last
CREMATION
DATE Month Day Year
DECEASED ype or print) t) Arthur
Michael
Romh
OF
IDEATH NOV_ I q
PLACE OF DEATH
CITY, TOWN, OR LOCATION
NAME OF (If not in hospital, give stri address)
COUNTY
HOSPITAL OR
— Indian River
Vero Rpjqt-h
INSTITUTION Ind'
Attending Physician X
(Name of Medical Certifier)
(A dress)
Medical Examiners L' Ronald
Bukoyy M.D.
1901
Funeral (Name)
(Address)
Home Strunk Funeral Home 734 No
Central Ave*
Sebastian, Florida 32955 i
Check A ❑ A completed certificate of death accompanies this application.
One
Fu I
eral
B [3 Dr. Ronald Bukowy was contacted on Nov. 16 ,19 -81 —.
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
gnature) (Fla. Lic. No.) (Date Signed)
BURIAL TRANSIT PERMIT
Permi
No
No. 1 228 -008
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.
❑ A five day extension of time for filing the death certificate has been requested and granted.
Method of Disposition
®
BURIAL
❑
CREMATION
❑
STORAGE
❑
OTHER(Specify)
Signature of Sexton
or Person in Charge
CEMETERY OR CREMATORY
Date of
Disposition November 18, 1981
Place of Sebastian Cemetery
Disposition
This permit must be endorsed by th exton or person in charge (or
within 10 days to the local county tealth department.
HRS Form 326 (1/77)
funeral director when there is no sexton) and returned