Pratt Marcantonio, P. Angelo #1EW I RK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last M Sex
• P. ANGELO DIVINO PRATT MARCH `T'ONIO MALE
Date of Death Age If Veteran of U.S.Armed Forces,
JAN. 12, 2006 1 DAY War or Dates
14 Place of Death Hospital, Institution
kA City,Town or Village City of Albany or Street Address ALBANY MEDICAL CENTER
Manner of Death Natural ❑ Undetermined r—i Pending
® Cause El Accident ❑ Homicide ❑ Suicide Circumstances Investigation
Medical Certifier Name Title
rai MICHALE J. HORGAN MD
Address
ALBANY MEDICAL CENTER, NEW SCOTLAND AVE., ALBANY, NY 12208
Death Certificate Filed District Number Register Number
City,Town or Village City of Albany 101 85
Date Cemetery or Crematory
® Burial JAN. 17, 2006 PINE VIEW CEMETERY
Address
❑ Cremation QUEENSBURY, NEW YORK
Date Place Removed
❑ Removal and/or Held
and/or Address
Hold
Date Point of
11, Transportation Shipment
CO ❑ By Common Destination
Carrier
❑ Date Cemetery Address
Disinterment
El Date Cemetery Address
Reinterment
Permit Issued To Registration Number
Name of Funeral Home M. B. KILMER FUNERAL HOME 01141
ef-
Address
71 136 MAIN ST., SO. GLENS FALLS, NY 12803
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
iii
:„ Permission is hereby granted to dispose of the human remains described above as indicated �Z�
�-'�
Date JAN. 13, 2006 Registrar of Vital Statistics ' -s'u � Q Q
94.4 Issued (signature)
6-0
District Number 101 Place City of Albany, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 1/17/nh Place of Disposition PINE VIEW CEMETERY,QUEENSBURY NY
Ui (address)
W MOHICAN 45-A 1-A
0 (section) (lot number) (grave number)
0 MICHAEL (DENIER
ZName of Sexton or Person in Charge of Premises
(please print)
Signature Title
SUPT.
(over)
DOH-1555 (9/98)