Abare, Gail NEW YORK STATE DEPARTMENT OF HEALTH # Ig
Vital Records Section Burial - Transit Permit
::: Name First Middle Last Sex
Gail A. Abare Female
:. :Date of Death Age If Veteran of U.S. Armed Forces,
'.�' March 7, 2016 74 War or Dates
i▪'• Place of Death Hospital, Institution or
• City, Town or Village Glens Falls Street Address Glens Falls Hospital
iii Manner of Death X Natural Cause Accident I 1 Homicide Suicide Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
,. Robert Love MD
Address
:;i: 3 Irongate Center,Glens Falls,NY 12801
Death Certificate Filed District Number Register Num4gr
City, Town or Village Glens Falls 5601 IN.▪. E Burial Date Cemetery or Crematory
March 9, 2016 Pine View Crematorium
❑Entombment Address
❑x Cremation 51 Quaker Road, Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
H Hold
Cl)
O Date Point of
NTransportation Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued io Registration Number
:;:; Name of Funeral Home Regan& Denny Funeral Home 01444
Address
94 Saratoga Avenue, South Glens Falls,NY 12803
:,:;: Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
S. Address
t5
Ai
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued '3 )g l f 6 Registrar of Vital Statistics W t.A.ievNo
(signature)
District Number 5601 Place Glens Falls, N L)
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
W Date of Disposition 3/Io hi, Place of Disposition f AL./ a,.rrnr ,,,,._
2 (address)
W
co
cc (section) ni _(lot number)-- (grave number)
p `/'Name of Sexton or Person in Charge f Premises h, ha''. 3IAwit
Z (pse print)
IllSignature �� it Title R`1 w�
(over)
DOH-1555(02/2004)