Howard, Edgar " NEW YORK STATE DEPARTMENT OF HEALTH
1 Vital Records Section Burial
p • - Transit Permit
T .
Name First Middle Last Sex
EDGAR •• E. HOWARD Male
Date of Death Age If Veteran of U.S. Armed Forces,
<"> July 16, 1995 74 War or Dates WWII
Place of Death Hospital, Institution or
City, Town or Village Glens Falls, NY Street Address Glens Falls Hospital
Manner of Death Natural Cause �Accident �Homicide []Suicide Undetermined Pending
. .�
�► Circumstances Investigation
C Medical Certifier Name Title
Gerard F. Abess, M.D.
Mi Address
3 Irongate Center Glens Falls, NY 12801 -
., Death Certificate Filed District Number Register Number
><' City, Town or Village Glens Falls, NY 5601 3 6
(� Date Cemetery or Crematory
L_TBurial July 19, 1995 Pine View Cemetery
nr—t Address
i._ICremation Quaker Raad Queensbury, NY 12804
Date Place Removed .
tt-❑Removal and/or Held
and/or Address
0 Hold
Date Point of
u[]Transportation Shipment
p by Common Destination
Carrier
Date ' Cemetery Address
ID Disinterment
[l Reinterment Date Cemetery Address
Permit Issued to Registration Number
< Name of Funeral Home Singleton-Healy Funeral HOme, Inc. 01807 •
ft
>< ; Address ,
407 Bay Road Queensbury, NY 12804 ..
'`` Name of Funeral Firm Making Disposition or to Whom •
" Remains are Shipped, If Other than Above .
Address
Permission is hereby granted to dispose of the human remains described above as indi ted.
Date Issued July 18, 1995 Registrar of Vital Statistics rf=
:li (signature)
"' District Number 5601 Place City of c;i PnG Fa 11s, NY 12801
I certify that the remains of the decedent identified above were disposed of In accordance with this permit on:
i -:
. Date of Disposition 7/19/9 5 Place of Disposition...P; n P v;esa ce ae t,e r y Que a n s b t r-y--N Y' 12 6 0 4
):! (address)
(section)Mohawk55 1
(lot number) (grave number)
0 (Jame of Sext.• •r Person in barge of Premises Rodney G. Mosher
7 (please print)
Signatur: , ,,, y ._, Title Supt .
DOH-1555 (10/89) p. 1 of 2 VS-61
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