(FORM D.) STATE OF MAINE. BURIAL PERMIT. Imment me Me., DEC 29 1909. Permission is hereby given Lth. Rumill to remove the remains of Charles H. Thurstone Date of Death, 12/24 1909. Age, 59 years, O months, 27days. Place of Death, Rockland me Ward, 3 Street, maple No. 2 Cause of Death, Ulwafthe Stomach with Peralonitis and ,Medical Attendant, airt goss Reckland me v To Cleasant Hill for interment, 12/29 1909. No. 15 albut S moore Town Clerk.