Hunt, Patricia NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Patricia Lou Hunt Female
Date of Death Age If Veteran of U.S. Armed Forces,
November 2, 2014 83 War or Dates
}., Place of Death Hospital, Institution or
• City, Town or Village Glens Falls Street Address Glens Falls Hospital
pManner of Death ❑X Natural Cause n Accident n Homicide ❑Suicide n Undetermined ri Pending
1i1 Circumstances Investigation
W Medical Certifier Name Title
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Address
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Death Certificate Filed I �� District Number Register Number
City, Town or Village Glens Falls,NY 5601 .SD
Li Burial Date Cemetery or Crematory
November 7, 2014 Pine View Cemetery
❑Entombment Address
❑Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z ElRemoval and/or Held
and/or Address
H Hold
CO
O Date Point of
fjj ❑Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
n Renterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Road, Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
h- Remains are Shipped, If Other than Above
M Address
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Permission is hereby ranted to dispose of the human remains describi ddbb a ye in .
Date Issued /y oV/' O/7 Registrar of Vital Statistics
(signature)
District Number 5601 Place Glens Falls,NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
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tu Date of Disposition )1 '7 264 Place of Disposition , / &a tim__, 6 a 0C_ _
2 (address)
co ( 5/ 1 ` 0Gta.�7/e� i
s tion) (lot number) (grave number)
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Name of Sex n or Person in Charge of Pre 'ses Cj, f'U 2 L. )of�D e:4
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Signature I�CGt.t.� t. 6 DJ Title ?/U ,
(over)
DOH-1555(02/2004)
HUNT Lot No. 5 4 A
Address 9 Luzerne Road, Queensbury, NY 1 2804 Section NO.
Owner David Hunt Plot Mohawk
Date 11 /3/30-14 ej)!
Approx. 33 Superficial ft. ((�
Location Bounded on the North by Howard, East by LaFera
West by Bolster and South by Hunt
Corner Posts
Remarks
Deed No. (and changes) 3873
Payment Record Paid in full on 11 /7/2014 ($600. 00)
Record of Interments
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Form No. 01 Q
()\43'
11Ah11 Patricia Lou Hunt ��Age: 83
Cause: natural
Lot Owner: David Hunt
Lot #
Grave # 54-A Mohawk
Case # 1
Died: concrete
Interred: 11 /2/201 4
Undertaker: 1 1 /7/201 4
Regan Denny Stafford