Shoemaker, Dorothy Edith (? - 1932)
Surnames: Shoemaker, Smith
----Source: Butler Township, Clark County, Wis. Death Records
Dorothy Edith Shoemaker
Butler, Clark County, Wisconsin
STATE OF WISCONSIN
Penalty for Burying Without a Permit, $20 - $200
Thorp, Wis. May 18, 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 Dorothy Edith Shoemaker
Who died at Town of Butler in the county of Clark
On May 18, 1932 the cause of death being lack of vitality
Place of burial: Butler Cemetery
(Signed by) Myrtle R. Smith
(Registrar, Deputy or Sub-Registrar)
Undertaker or person in charge (Sexton)
E. A. Shoemaker
Date of internment: May 18, 1932
(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
1. Name of deceased: Dorothy Edith Shoemaker
2. Place of burial: Butler Cemetery
3. Date and place of death: May 18, 1932
R 2, Town of Butler
4. Disease causing death: Lack of Vitality
5. Cause of death given by: B. A. Cole, M.D.
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