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Parsons, Nancy NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex E; Nancy Marlene Parsons Female , Date of Death Age If Veteran of U.S.Armed Forces, 12/17/2017 63 Years War or Dates ! Place of Death Hospital, Institution or City, Town or Village Albany Street Address Albany Memorial Hospital Manner of Death©Natural Cause ❑Accident 0 Homicide ❑Suicide ❑Undetermined ri❑Pending Circumstances Investigation w Medical Certifier Name Title Nadine Kalavazoff MD Address I 600 Northern Boulevard,Albany,New York 12204 Death Certificate Filed District Number Register Number City, Town or Village Albany 0101 2792 q v®Burial Date Cemetery or Crematory 12/23/2017 Pine View Cemetery El Entombment Address ❑Cremation Queensbury Town, New York - Date Place Removed ©❑Removal and/or Held and/or Address Hold Date Point of 0 Transportation Shipment by Common Destination Carrier El Disinterment Date Cemetery Address Date Cemetery Address ❑Reinterment ' Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address p 68 Main Stpo Box 67,Hudson Falls,New York 12839 '' Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address W Permission is hereby granted to dispose of the human remains described above as indicated. '; Date Issued 12/19/2017 Registrar of Vital Statistics OanierreS gia spie EfrctronicaaySigned. (signature) �i _il, District Number 0101 Place Albany, New York I certify that the remains of the decedent identified above were disposed of in a cordance with this permit on: Z. Date of Disposition /a, a3 1"t Place of Disposition / &Vett_ , Ill I _ (address) LA A' o' n) / I number) (grave number) Name of Se n or Person in Charge of Premises Nutt/6 I.-- G� (p se print) Pr ' Q Signature fdtu eed-14-{...---- Title��L��"i7JG�Q�Irt, (over) DOH-1555 (02/2004)