Lemery, Margaret NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
MARGARET M. LEMERY Female
Date of Death Age 1 If Veteran of U.S. Armed Forces,
February 28, 1996 85 1 War or Dates none
Place of Death Hospital, Institution or
Glens Falls, NY Glens Falls Hospital
City, Town or Village Street Address
Manner of Death C Natural Cause n Accident 0 Homicide n Suicide Undetermined 0 Pending
LU Circumstances Investigation
Qui Medical Certifier Name Title
gi. James F. Hindson, M.D.
Address
90 South Street Glens Falls, NY 12801
Death Certificate Filed District Number Register Number
iiiiiii City, Town or Village Glens Falls, NY 5601 c,
i__7' Date Cemetery or Crematory
( Burial March 1 , 1996 St. Alphonsus Cemetery
Address
❑Cremation Luzerne Road Queensbury, NY 12804
Date Place Removed
0❑Removal and/or Held
••• and/or Address
Hold
0 Date Point of
N❑Transportation Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
pi Name of Funeral Home Singleton-Healy Funeral Home, Inc. 01807
Address
407 Bay Road Quenesbury, NY 12804
''` Name of Funeral Firm Making Disposition or to Whom
[ "" Remains are Shipped, If Other than Above
Address
>I
liPi Permission is hereby granted to dispose of the human re ains described/ri bove as indicated.
Date Issued FEB 29, 1996 Registrar of Vital Statistics / ,- .�`�
ni (signature)
5601 Place City of Glens Falls, NY 12801
District Number
lFI certify that the remains of the decedent identified above were disposed of in accordancewith this Qermit on:. & Luzerne
- rner inebt
W Date of Disposition 4/19/96 Place of Disposition St. Aiphonsus Cemetery, Queensbury, NY 12804 •
(address)
iA Section "C" 1 1
CC (section) (lot number) (grave number)
GName of Sexton or Person in C ae of Premises Edmund E E. Parrow, Jr.
Z 4 _ .,
_ _ . (please print)
W Signature f ��-""_ L.-_Gr._--a--d Title cemetery Foreman
DOH-1555 (10/89) p. 1 of 2 VS-61