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Dunphy, Betty NEW YORK STATE DEPARTMENT OFHEALTH ���D�~��� ~ �~�������~� �����R��~� Bureau cfB�ot��1�m 'Vho Records Section ����" m~~n mm �=.°~~o� m- ~°. "."u� Name First Middle Last Sex BETTY E. DUNPHY -bate of Death Age If Veteran of U.S.Armed Forces, 2/14/88 75 War or Dates N/A Place of Death Hospital, Institution or -:Uj City,Town or Village Street Address Saratoga Springs Saratoga HOSPITAL Cause of Death CARDIAC ARREST UJI Medical Certifier Name Title Death Certificate Filed District Number Register Number City,Town or Village Saratoga Springs 4501 Date Cemetery or Crematory Burial 2/16/88 Address F1 Cremation Place Removed Date 0 El Removal and/or Held Address Date Point of f Shipment Destination Date Cemetery Address El Disinterment Cemetery Address Date El Reinterment Permit Issued to Registration Number NomoofFunero|Firm SULLIVAN ]�I0JQl�� & POTTER INC. 02397 ^-`^'~~`~^~~~^~```~~``~^``^^^-~~~~~``'~~'^~`~~~`~^~~^``'^~`~~```~'~^`^~`~~'~~~'^~~~~-~'~~~~~^~ A dress 67 PARK ST. GLENS FALLS NY 12801 4;; Name of Funeral Firm Making Disposition or to Whom Remains Shipped, Address u rn a�n;�a�11 n s C I d a ve as Indicated. Permission Is hereby granted to dispose of the dea Date Issued 2/16/88 Registrar of Vital Statistics District Number 4501 PlaceSuru�o8u Springs �� l2866 I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date cdDisposition Place ofDisposition LLJ (address) LU (section) (lot number) (grave number) Name cdSoctonor Person in Charge ofPremises (please print) LU Signo8ura Title