Murphy, Cora NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
vital Records Section
Name First Middle Last Sex
CORA LILY MURPHY FEMALE
447- Date of Death Age If Veteran of U.S.Armed Forces,
10/23/11 26 DAYS _ War or Dates NO
E. Place of Death Hospital, Institution
Z; City ,Town or Village City of Albany or Street Address ALBANY MEDICAL CENTER
p' Manner of Death Natural Undetermined Pending
W ❑ Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Circumstances ® Investigation
illMedical Certifier Name Title
a JOHN KEEGAN CORONER
Address
112 STATE ST. ALBANY, NY 12207
Death Certificate Filed District Number Register Number
City,Town or Village City of Albany 101 1980
Date Cemetery or Crematory
® Burial 10/28/11 PINE VIEW CEMETERY
❑ Entombment Address
❑Cremation QUEENSBURY, NY
Z Date Place Removed
Removal and/or Held
0 and/or Address
' Hold
N
a' Transportation Date Point of
Cf) ❑ By Common Shipment
p Carrier Destination
❑ Date Cemetery Address
Disinterment
Date Cemetery Address
❑ Reinterment
Permit Issued To Registration Number
Name of Funeral Home M.B. KILMEDR FUNERAL HOME 01078
z Address
136 MAIN STREET SO. GLENS FALLS, NY
Name of Funeral Firm Making Disposition or to Whom
F"' Remains are Shipped, If Other than Above
gAddress
W''
Cl!.._ Permission is hereby granted to dispose of the human remai escribed above as indicate
IssuedDate 10/25/11 Registrar of Vital Statistics c v ON--
(signature)
4 District Number 101 Place City of Albany, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition 1 0/28/1 1 Place of Disposition Pine View Cemetery
to (address)
E
cn Erie 37A 1
ct
0 (section) (lot number) (grave number)
0
z Name of Sexton or Person in Charge of Premises Michael Genier
(please print)
Signature` 9dL,v...4.AI) Title Superintendent
(over)
DOH-1555(02/2004)