Cronin, Deborah NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
I Name First Middle Last Sex
Deborah Lynn Cronin Female
Date of Death Age If Veteran of U.S.Armed Forces,
7/15/2016 63 War or Dates
t- Place of Death Hospital,Institution or
W City,Md09(yt6 Glens Falls Street Address Glens Falls Hospital
p Manner of Death®Natural Cause Q Accident 0 Homicide El Suicide 0 Undetermined �Pending
VCircumstances Investigation
iji D Medical Certifier Name Title
Melissa Decker MD
Address
I 9 Carey Road Queensbury NY 12804
Death Certificate Filed - District Number Reg, -. , i,..-r
�Y.TlP1 ar kia Glens Falls 5601 t
toBurial Date Cemetery or Crematory
7/20/2016 St. ATphonus Cemetery
I0mt
' Address
['Cremation Pine St Queensbury NY 12804
Date Place Removed
Z❑Removal and/or Held
and/or Address
m Hold
O Date Point of
„,mitt 0Transportation Shipment .
a by Common Destination ••
Carrier
(]Disinterment Date Cemetery Address
0 Reinterment Date Cemetery Address
J
Per issued to Reg45
ttraton Number
NameofFuneralHomeRad1off Funeral Home Inc. 1Address
136 Warren Glens Falls NY 12801
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped,if Other than Above
X Address
Ce
'Ii
13.
Permission Is)) by granted to dispose of the human wins d oribed a ve as indi ted
Date Issued (}� /��, Registrar of Vital Statistics i/1�..r t° ���
District Number.fl6 /1Place
WI certify that the remain of decedent identified above were disposed of in accordance this permit on:
Date of Disposition 7201/4, Place of Disposition •S4. 4 16-4 i.4 £tea ty
w (a )
CC (section) fl4 /� 3 ery (grave number)
NameofSext• rof Premises ,
2 (please pang
Ui
Signature / Title
(over)
DOH-1555(02/2004)