Skane, Margaret NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
ICr This permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Primary Registration District
(Town, Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTI-
FICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Registered No. A
�601 Warren Town, Village
Dist. No. County or City City of Glens Falls
If city, give street address)
Name of deceased Margaret Skane Veteran No
(If veteran, give name of War)
Female Single, married,widowed,
Sex or divorced (write the word) Widowed Date of Death Nov. 18 19_.28
Age 68 Years Months Days Birthplace Ne_w-_Yor_k___S.tate
Cause of Death csr d. .QZeIti.C____S_t1 1Ck
Certificate was signed by William N. St,John, M.D.
Address 464._G1gAr...St-,_.,51ens Falls, N„Y,
Place of Burial (or Removal) Town of Queensbury., N.Y.
(If body is to be to orarily )d, fill i space later)
Cemetery dine View Cemetery Date of Burial NOV. 20 19__.t_._
(If body is to be temporarily held, fill in space later)
The CERTIFICATE OF DEATH containing the above stated particulars, having been presented to me, after careful examination,
the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same
for registration, have recorded it in my Local Record with the above stated Registered Number, and on the basis thereof I HERE-
BY GRANT A PERMIT
to Regan & Denny, Inc. quaker Rd. ,Glens Falb,, N.Y.
(Name) (Address)
the Undertaker to hold temporarily and In ..r.____ the body
(Unlertaker or person having charge of corps (I move, q� oth ise pose of ( e how))
Dated /I --07_(,1 19_f (Signed) r�///
Local Re tray
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local
cemetery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
FORM VS.61.(REV.6/63)(7A2-53)
ENDORSEMENT OF SEXTON OR PERSON IN
CHARGE OF PREMISES ON WHICH INTERMENTS
OR CREMATIONS ARE MADE
Date o ' C.fw as ""�'919 2 Y
(Interment or
(Name of Cemetery, CrernB or um,
Section —�'=L Lot No. ` Grave No. 47
(Signed)
(Person in Charge)
Address 72, ' /✓'
Person in charge must return this Permit to the Registrar
of his District within SEVEN (7) DAYS from above date.
If no person is in charge, the FUNERAL DIRECTOR or
UNDERTAKER MUST SIGN ABOVE STATEMENT,
write across the face of the Permit the words "No person in
charge," and FILE PERMIT WITHIN THREE (3) DAYS
with the Registrar of District in which cemetery is located.
SEXTONS, FUNERAL DIRECTORS and UNDER-
TAKERS violating the law relative to the return of permits
are liable to a penalty of NOT LESS THAN FIVE DOL-
LARS NOR MORE THAN FIFTY DOLLARS FOR THE
FIRST OFFENSE. The law will be enforced. Local Regis-
trars are required, under penalty, to report violations thereof.