Ryan, Beatrice NEW YORK STATE DEPARTMENT OF HEALTH l6;7
Vital Records Section .7f... .- : Burial - Transit Permit
Name First Middle Last Sex
Beatrice I Ryan Female
Date of Death Age If Veteran of U.S.Armed Forces,
}. April 1, 2006 81 War or Dates
Z Place of Death Hospital, Institution or
W City, Town, or Village Glens Falls Street Address Glens Falls Hospital
•
G Manner of Death ® Natural Cause 0 Accident 0 Homicide 0 Suicide n Undetermined El Pending
W Circumstances Investigation
Medical Certifier Name Title
W L'hri er 1--loti ►t✓I b.
Q Address n
IDZ PAR T. Q(0_5 g,tcs it.1r. izEd/
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls •,-- /y3
El Burial Date Cemetery��Crematp ry
/5lol 121de ►(Ek) CAzik4-iv�e.ra�
El Entombment Address
▪ 171 Cremation citU41(P7-- 7d, 0 utzioA ice. iigDate Place Removed ""'l7
0 111 Removal and/or Held
- and/or Address
I- Hold
0 Date Point of
0 0 Transportation Shipment
i by Common Destination
Carrier
Date Cemetery Address
aEi Disinterment
n Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan & Denny Funeral Service O/$/el
Address
53 Quaker Rd. , Queensbury, New York 12804
Name of Funeral Firm Making Disposition or to Whom
2 Remains are Shipped, If Other than Above
Ui Address
Permission is hereb granted to dispose of the human remains described boved. in . e .
Date Issued oy3/OC Registrar of Vital Statistics Ze,
(signature)
District Number 6-60/ Place Glens Falls,New York
F I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
2
ill Date of Disposition Place of Disposition
2 (address)
Ul
0 (section) (lot number) (grave number)
0 Name of Sexton or Person in Charge of Premises
2 (please print)
III
Signature Title
(over)
DOH-1555 (02/2004)