Obit: Henderson, Stillborn Twins (1932 - 1932)
Contact: stan@wiclarkcountyhistory.org

Surnames: Henderson, Reineke, Smith

----Source: Butler Township, Clark County, Wis. Death Records

 

Henderson twins

Butler, Clark County, Wisconsin

 

STATE OF WISCONSIN

BURIAL PERMIT

Penalty for Burying Without a Permit, $20 - $200

 

Thorp, Wis. Dec 9, 1932

                                                                                  (City, Township or Village)

 

A satisfactory certificate of death having been furnished to me, as required by the laws of this State, permission is hereby given for the burial of  Henderson twins

Who died at  Butler, R3, Thorp, Wis   in the county of  Clark

On Dec 8, 1932                                 the cause of death being  still born

 

Place of burial:  Butler Cemetery

                                                                 (Signed by)  Myrtle R. Smith

                                                                    (Registrar, Deputy or Sub-Registrar)

                                                                               Roy R. Reineke

Undertaker or person in charge                                      (Sexton)

 

Date of internment: 

                                                                                           (Name of Cemetery)

 

This permit must be delivered to the keeper of the cemetery where the burial occurs, and should be endorsed by him and returned to the local registrar of his district.

 

____________________________________________________

THIS "STUB" TO BE KEPT BY PERSON ISSUING PERMIT

 

______

 

BURIAL PERMIT

______

 

1.  Name of deceased:  Henderson (twins)

 

2.  Place of burial:  Butler

 

3.  Date and place of death:  Butler R 3 Thorp

 

4.  Disease causing death:  Not known

 

5.  Cause of death given by:  B. A. Cole, M.D.

 

 

6.  Undertaker: 

 

 

 

 


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