Yunich, Mary NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle - Last Sex
Mary Aronson YUNICH Female
liiiiii Date of Death Age I If Veteran of U.S. Armed Forces,
MAR 5, 2006 95 I War or Dates
0.4 Place of Death I Hospital, Institution or
.2 City, Town or Village City of Albany Street AddressAlbany Medical Center Hospital
pManner of Death 0 Natural Cause El Accident ^Homicide El Suicide El Undetermined C Pending
Circumstances Investigation
iti Medical Certifier Name Title
Dr. Aniko Fellegi MD
Address
43 New Scotland Ave. Albany NY
iiii Death Certificate Filed District Number Register Number
ili City, Town or Village City of Albany 101
Date Cemetery or Crematory
®Burial MAR 8, 2006 Shaaray Tefila Cemetery
Address __ —
❑Cremation Queensbury NY
Date Place Removed
0 Removal and/or Held
— and/or Address
Hold
0 Date Point of
05 El Transportation 1 Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
j
Permit Issued to Registration Number
i Name of Funeral Home Regan & Denny Funeral Home 01519
ag Address
53 Quaker Rd. Queensbury, NY 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
104 Address
Permission is hereby granted to dispose of the human rem ands cribpdd at�ove as indicated.
i Date Issued 3-CAS- Registrar of Vital Statistics Place �I ,,.7t. , � ..-- 11 --�"
signafie)District Number 101 Albany Police Depaix
mcnt Albany, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Lu Date of Disposition ,-)j1 (A® Place of Disposition s ifs 1 1 11 k
2 l (address)
tn
Er rion) (lot numb r) (grave number)
Name of Sexton or Person in Charge of Premises_ `.1 ,p�z se prink
Signature Title CQ,t,� ' ���-
i.J C
(over)
DOH-1555 (9/98)