De Voe, Elizabeth NEW YORK STATE DEPARTMENT DFHEALTH ���N�~��N ~ ����N����~� ��*����^�
Vha| R000�nSe��n ��~~~ "~~° Transit Permit
Name First Middle Last Sex
Elizabeth
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City,Town ovVillage --
Town o� Queenab S1n*� �ddnmo Weatmount Health Facility
:.Lu Homicide [] Suicide
Manner of Death [g] Natural CauseE] Accident Ei Undetermined E] Pending
Circumstances Investigation
_----_--------'������'____-___-_-__---__-___-_____Albert Paolano __-__-----_---------------_-___ -�
90 South Street, Glens Falls, New York 12801
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Death Certificate Filed
Registe
City,Town ovVillage City of Glens Falls 4"�-
Date Cemetery orCrematory
8uria| July 17, 1991 Pine View Cemetery
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� FlCmma1�n 8�Ureo» Town of Quoannbury, Now York
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-Removed
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Address
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-� Permit Issued to
Registration Number
Name of Funeral Firm Regan and Denny Funeral Service, Inc. 01602
Address
26 Quaker Road, Queensbury, New York 12804
Name of Funeral Firm Making Disposition or to Whom
:.nw Remains are Shipped, If Other than Above ...........
Address
se of the h
Permission is hereby granted to dispo mains described abovelp di
Datelssued
Registrar of Vital Statistics ur,-re
Place
District Number
I certify that the remains of the decedent identified above were di-sosed of in accordance with this pe it 0
it
Date ofDisposition 7-/7-V/ Place ofDin /« ��
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' Name of Sexton o,Person in Charge naPremises 10e- z�'
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LU Signature Till /��/� l`^/ �� +-V�^r~,+/����'
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