Strainer, Patricia NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Patricia Ann Strainer Female
Date of Death Age If Veteran of U.S. Armed Forces,
November 8, 2012 61 War or Dates
Place of Death Hospital, Institution or
Z City, Town or Village Queensbury Street Address Old Aviation Road
QManner of Death n Undetermined Pending
� X Natural Cause Accident Homicide Suicide
Circumstances Investigation
kis Medical Certifier Name Title
-!Q Aqeel Gillemi MD
Address
102 Parks Street Glens Falls,NY
Death Certificate Filed District Numbe5657 Register Number
City, Town or Village Queensbury /4/r
El Burial Date Cemetery or Crematory
Ili Entombment November 12, 2012 St. Alphonsus Cemetery
Address
❑Cremation Pine Street, Queensbury, NY 12801
Date Place Removed
Z — Removal and/or Held
and/or Address
F' Hold
Cl)
O Date Point of
chTransportation Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
n Reinterment
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
;M Remains are Shipped, If Other than Above
!F Address
1
ttf
Q' Permission is hereby granted to dispose of the human r ains described//' a e as ndicated.
-: Date Issued jJ— &/1- Registrar of Vital Statistics �� !'�'l.-
(sign ture)
District Number 5657 Place Queensbury
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
LIJ• Date of Disposition f t l !2i l Z Place of Disposition P tr t. s i Q Deus bu rsy Nc 12 Y(
(address) 1
ILI
SEA C ;I3 y
re
(sJp n) (lot number) (grave number)
Op Name of Sexton or Person in Charge of Premises VAvt C . k•-, k'7
Z (please rint)
W Signature - Title I \* e
(over)
DOH-1555(02/2004)