Cronin, Terese NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Terese M. Cronin Female
Date of Death Age If Veteran of US Armed Forces,
1 December 17, 2015 89 War or Dates No to
'' Place of Death Hospital, Institution or
;R City, Town or Village City of Plattsburgh Street Address Meadowbrook Healthcare Facility
Manner of Death Undetermined Pending
1 Natural Cause Accident Homicide Suicide
T. Circumstances Investigation
Medical Certifier Name Title
Brenda Phillips M.D.
Address
Plattsburgh, New York 12901
Death Certificate Filed District Number Register Number
City,Town or Village City of Plattsburgh 901
Burial Date Cemetery or Crematory
December 22, 2015 St.Alphonsus Cemetery
Cremation Address
Entombment Glens Falls. New York
Removal Place Removed
and/or
and/or Held
Hold Address
glTransportation Shipment
1 Date Point of
by Common
't Carrier Destination
Disinterment Date Cemetery Address
Reinterment
Date Cemetery Address
Permit issuedTto Registration Number
Name of Funeral Home Brown Funeral Home, Inc. 00226
Address
29 Broad St. Plattsburgh, NY 12901
Name of Funeral Firm Making Disposition or to Whom
' Remains are Shipped, If Other than Above
Address
i
Permission is hereby granted to dispose of the human remains describe abov as indicated.
12-1 8-201 5 TV,� Date Issued Registrar of Vital Statistics i' l!/�l� 7, ,iti
(signature)
' ? District Number 901 Place City of Plattsburgh
1
I certify that the remains of the decedent identified above were dis oseds of in accorda/ ce with, his permit on:
�ZSi /Loi9 SLs S Oit,e �� „hi.)Date of Disposition lL� JirPlace of Disposition - P
Jr (address) ai
/7
(section) (lot n ber) (grave number)
Name of Sexton or Per n in arge of Premises /#4."
ii'
(please prin
Signature Title
DOH-1555 (02/2004)