Kranzmann, Thelma NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle Last Sex
im Thelma Lena Kranzmann Female
Date of Death Age If Veteran of U.S. Armed Forces,
April 8, 1998 80 War or Dates
Place of Death Hospital, Institution or
City, Tc X Glens Falls Street Address Glens Falls Hospital
mii Manner of Death Undetermined Pending
lil ®Natural Causes[1]Accident ❑ Homicide ❑ Suicide ❑ Circumstances ❑ Investigation
iiiii Medical Certifier Name Title
David H. Thompson MD
Address
88 Broad St, Glens Falls, NY 12801
Death Certificate Filed District Number Register Number
< 'Cityiiiiiiii , T K x Glens Falls 5601 ) 9
Date Cemetery or Crematory
❑ Burial April 9, 1998 Pine View Crematorium
InCremation Address
Tn of Queensbury, NY 12804
Date Place Removed
n Removal and/or held
and/or hold Address
Date Point of
❑ Transportation by Shipment
Common Carrier
Destination
Date Cemetery Address
❑ Disinterment
Date Cemetery Address
❑ Reinterment
:::Permit issued to Registration Number
>«<[Name of Funeral Firm Carleton Funeral Home Inc. 00313
IIII Address
iMi P.O. Box 67, 68 Main St., Hudson Falls, N.Y. 12839
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Mi
Permission is hereby granted to dispose of the human remains described above as indicatedit .
/
iiiig Date Issued /S/ct Registrar of Vital Statistics -O / Z%23
(Signature)
5601 Glens Falls, NY 12801
wi District Number Place
certify that the remains of the ecedent identified above were disposed of in accordance with this permit on:
Date of Dispositio Place of Disposition Pi ,mil rE4 C R./v,,777/l u 1
(address)
(Section) � (Lot Number) (Grave Number)
Name of Sexton or Person in Charge of Premises����/1/�1/j� /�//I/97/)ntif
(Please Print) --,� r� r...—
Signature Title v�J 44 497 /j �S5/
y
DOH-1555 (10/89) p. 1 of 2 VS-61