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Meath, Margaret NeW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Margaret Elizabeth Meath Female Date of Death Age If Veteran of U.S. Armed Forces, May 19,2017 91 War or Dates NA Place of Death Hospital, Institution or Z City, Town or Village Glens Falls Street Address Glens Falls Hospital pManner of Death n Natural Cause n Accident --Homicide Suicide Undetermined Ti Pending IA Circumstances Investigation Medical Certifier Name Title CI Suzanne Blood MD Address 161 Carey Rd.Queensbury,NY 12804 Death Certificate Filed District Number �� �t RegisntrTer City, Town or Village `^J�)�[v ®Burial Date Cemetery or Crematory May 24, 2017 Pine View Cemetery ❑Entombment Address El Cremation Quaker Road, Queensbury, NY 12804 Date Place Removed OZ ❑Removal and/or Held and/or Address H Hold U) O Date Point of Nn Transportation Shipment p by Common Destination Carrier n Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Road, Queensbury, NY 12804 Name of Funeral Firm Making Disposition or to Whom 1 Remains are Shipped, If Other than Above Address ' Permission is hereby granted to dispose of the human mains d scribed bove as ind' ated Date Issued Q.�.. ("401 Registrar of Vital Statistics ey1J�i-7 L �/1-e �� © FC.(--0/ s gnatur�District Number .54� / Place �i �i -1 I certify that the remains of the decedent identified above were disposed of in accordanc with this permit on: W Date of Disposition Place of Disposition W (address) co re (section) (lot number) (grave number) pName of Sexton or Person in Charge of Premises Z (please print) W Signature Title (over) DOH-1555(02/2004)