Breen, Margaret NEW YDRK STATE DEPARTMENT OFHEALTH ��NN�~��0 ~ �����R���^� B�m~�8��~�
Vital Records Section
��~~~ ~~~~ Transit Permit
Name First Middle Lost Sex
Margaret A. Breen 0smle
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of Death Age
l2-l-9U � 92 }«�^ War or D/�ao
No
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:.;4 Place of Death Hospital, Institution or
City,Town or VillageGlens Falls NY Street Address Glens Falls HosDital, Glens Falls.-NY 12801
0, Undetermined Pending
N Manner of Death &
Natural CauseE] Accident [:]Homicide Ej Suicide CircumstancesEl Investigation
Medical Certif ier Name Title
Robert 8 Beaty MD
....................____.____�������_._^`__________--___-----__-_-_---_-_-_________---___---_-_____--._-----.-'- ----'
3 I±rmgzte Center, Glens Falls, 0Y 12801
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Certificate Filed
�0 City,Town orVillage GImma Falls, NY 5601 le /\
Date Cemetery nrCrematory
E*Buria| 12-4-90 Pine View (emater��,
FlCmmou�n auu,ouv
� �� Vue*subucy , 0Y I2804
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�u uom r��nnomuvou
[] Romova and/or Held
and/or Hold ---- ---
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,�m �lTronopo���nby � Shipment
czCommon Carrier ....�������--_--_____----_______-_-____________________________________________________________
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� Date Cemetery�6��*��rooa
_ El Disinterment
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El Roi�onnor� --' '
Permit Issued to Number
01850
Name of Funeral Firm
Address
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is here y granted to dispose of the hum in remains described above as indicated.
790 Registrar of Vital Statistics 7/4
Date Issued AJ J,
5601 City of Glens Falls, NY 12801
District Number Place
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date o/ Disposition /^^- /' ,= Place of "sp"""o'' / ^-+" `-=`�=��'`�� 2~�=='^~ ~^-^~/LLJ
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2 (address)
^'"°'^-~r^~
(section) (lot number) (grave number)
cc
! Name of S P i Chargec�Premises �� /�- '�/�'�
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V5-61