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Clift, Frances NEW YORK STATE DEPARTMENT OF HEALTH W I 1 b Vital Records Section _ Burial - Transit Permit eco ds Sect o `_ Name First Middle -Last Sex Frances Lillian Clift Female Date of Death Age If Veteran of U.S. Armed Forces, February 15, 2017 71 War or Dates Place of Death Hospital, Institution or City, Town or Village Street Address Saratoga Hospital Manner of Death Natural Cause ❑ Accident El Homicide ❑ Suicide ❑ Undetermined ri❑ Pending Circumstances Investigation Medical Certifier Name Title Stephen R. Offord, MD , Address 211 Church Street Saratoga Springs, NY 12866 Death Certificate Filed District Number Register tuber City Town or Village p� Aa n)l� 1 jbj" 9LD -❑Burial Date Cemetery or Crematory February 21, 2017 Pine View Crematory ❑Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed z ❑ Removal and/or Held Iand/or Address Hold Date Point of ❑Transportation Shipment by Common Destination Carrier v ❑ Disinterment Date Cemetery Address Date Cemetery Address El Reinterment Permit Issued to Registration Number Name of Funeral Home M. B. Kilmer Funeral Home-Argyle 01077 Address LI 123 Main St., Argyle NY 12809 _ Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above;,; e Address Permission is he eby ranted to dispose of the human remains describe 'abov s-i dicated. Registrar of Vital Statistics —_ �t�JL4Mc r Date Issued �� i l 9 / (signature) District Number , Place SAzom/A4, �C'7(,.�{�S . r r � I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 02/21/2017 Place of Disposition Quaker Road Queensbury,NY 12804 (address) (section) (lot number) µ (grave number) Name of Sexton or Person in Charge of yremises a(1)i S^`{te' ( lease print) -" Signature a Title Lh niVit (over) DOH-1555 (02/2004)