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Prescott, Doris NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit €l Name First Middle Last Sex >:, Doris A. Prescott female Date of Death Age If Veteran of U.S. Armed Forces, IP March 7, 1998 War or Dates no `' Place of Death 85 Hospital, Institution or City, Town or Village Town of Queensbury Street Address Hallmark Nursing Centre :.• Manner of Death©Natural Cause El Accident El Homicide El Suitide El Undetermined ri Pending Circumstances Investigation Medical Certifier Name Title xp Robert Beaty MD' Address • 2 Broad St. Plaza, Glens Falls, NY 12801 .?: Death Certificate Filed District Number Register Number ': City, Town or Village Town of Queensbury . fit" 3 Date • Cemetery or Crematory • ::::. LJ Burial March 10, 1998 Pine View Cemetery Address :'' El Cremation Queensbury, NY • • • gDate Place Removed 0❑Removal and/or Held • -- and/or Address Hold • • 2 Date • Point of N 0 Transportation Shipment 5 by Common . Destination . • Carrier. • . . - . :': [i Disinterment Date Cemetery Address ::':' 0 Reinterment Date Cemetery Address Permit Issued to • Registration Number Name of Funeral Home Regan and Denny Funeral Service • 01565 pi.1 Address 4:> • 53 Quaker.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 rem n described above as nd cated. Date Issued .3- 5 7l- Registrar of Vital Statistics JO— A ' j iiA (signature) ' '`f: District Number cs7 Place 1,«..e_42..,� HI certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 5 Date of Disposition 3/10/98 Place of Disposition Pine View Cemetery ,Queensbury,NY . (address) CD • Hudson #3 6 4 (section) (lot number) (grave number) t 'Name of Sexton or Person in Charge of Premises Michael Lopez z (please print) 4! Signature OTitle Working Foreman • DOH-1555 (10/89) p. 1 of 2 • VS-61