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Walter, Frances NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Vital Records Section Name First Middle Last Sex Frances J. Walter female ............................................................................... ................................................................................................................................................................................................ Date of Death Age If Veteran of U.S. Armed Forces, July 4, 1991 52 War or Dates No Z Place of Death Hospital, Institution or W City,Town or Village Town of Queensbury Street Address 11 Sherwood Drive W Manner of Death El Natural Cause 0 Accident ❑ Homicide ❑ Suicide ❑ Undetermined D Pending Circumstances Investigation ILI Medical Certifier Name Title b Mark Hoffman MD Address 7 Murray Street, Glens Falls, New York 1280 .,. Death Certificate Filed District Number Register Number City,Town or Village City of Glens Falls -E -Lri- __7 39 Date Cemetery or Crematory ®Burial July 8, 1991 Pine View Cemetery ❑Cremation Address Town of Queensbury, N. Y. Z Date Place Removed O ❑ Removal and/or Held H and/or Hold :::::: Address N a Date Point of N ❑Transportation by Shipment ca Common Carrier Destination ❑ Disinterment Date Cemetery Address ❑ Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Firm Regan and Denny Funeral Service, Inc. 01602 Address 26 Quaker Road, Queensbury, New York 12804 I- Name of Funeral Firm Making Disposition or to Whom a Remains are Shipped, If Other than Above ul Address a Permission is hereby granted to dispose of the hu a rem ins describ d bove as indicated. Date Issued 7)t/9/ Registrar of Vital Statisti r / ignat e District Number ..�IQJ ) Place -!-6e I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: F- Z Date of Disposition 7—i'—y/ Place of Disposition /9,0c-- e---74J (h�/r iey� 'c/t��rJSs ii/t/) n// 2 (address) N 5., ..LC 46,Z /g"O 2 cc (section) (lot number) (grave number) O' p' Name of S-- •n or 'erson in Charge of Premises disc/.= . ,,'o s ffy---/Q___ Z (please print) / W Signatur- � t ,�i1�c�-s�.�a. . Title r DOH-1555 (10/89) p. 1 of 2 VS-61 WALTER Lot No. 180 Address 11 Sherwood Drive, Oueensburv, Ny 12804 Section No. 2 Owner Mr. Frank ti Walter, Jr Plot S.I. Date 7/5/91 Approx. 67 Superficial ft. @ Location Bounded on North by Winters & Vacant, South by Miller, East by Gifford, West by Star Corner Posts Remarks Deed No. (and changes) 2366 Payment Record Paid in Full 7/5/91 Record of Interments a��� ' 2 Frances J. Walter 7/8/91 s 4 l 5 S 6 x , 7I 8 I //eW.._ Form No. 01 NAME Walter, Frances J. Age: 52 Cause: Natural Causes Lot Owner: Frank B. Walter, Jr. Lot # 180 S.I. #2 Grave # 2 Case # Concrete Died: 7/4/91 Interred: 7/8/91 Undertaker:Regan & Denny