Hunt, JoAnne ANEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle Last Sex
JO ANNE KINGSLEY HUNT FENALE
Date of Death Age If Veteran of U.S.Armed Forces,
06/08/2018 73 War or Dates NO
1"`, Place of Death Hospital, Institution
Z City,Town.or Village City of Albany or Street Address AMCH, ALBANY, NY
III
in Manner of Death Natural Undetermined Pending
W' ® Cause El Accident ❑ Homicide ❑ Suicide ❑ Circumstances ❑ Investigation
W, Medical Certifier Name Title
OLGA MARTIN, PA-C
Address
AMCH, 43 NEW SCOTLAND AVE, ALBANY, NY 12208
Death Certificate Filed District Number Register Number
City,Town or Village City of Albany 101 1271
Date Cemetery or Crematory
® Burial 06/12/2018 PINE VIEW CEMETERY
❑Entombment Address
❑Cremation QUEENSBURY, NY 12804
Date Place Removed
Z Removal and/or Held
Q ❑ and/or Address
F Hold
Date Point of
p 2 Transportation Shipment
(J) ❑ By Common p Destination
' Carrier
❑ Disinterment Date Cemetery Address
❑ Date Cemetery Address
Reinterment
Permit Issued To Registration Number
Name of Funeral Home REGAN DENNY STAFFORD FUNERAL HOME 01443
Address
53 QUAKER ROAD, QUEENSBURY, NEW YORK
Name of Funeral Firm Making Disposition or to Whom
F- Remains are Shipped, If Other than Above
, Address
uf
Q. Permission is hereby granted to dispose of the human remains desc i ed above a ndic
Date 06/11/2018 Registrar of Vital Statistics C���� /
Issued (signature)
District Number 101 Place City of Albany, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
z Date of Disposition 6/1 2/201 8Place of Disposition Pine Vi Pw Cemetery Queensbury
w (address)
2
w Seneca 5-A 1
0 (section) (lot number) (grave number)
0
Z Name of Sexton or Person in Charge of Premises Connie Goedert
Ili (please print)
Signatur 0 (d.' L'C' Title Cemetery superintendent
(over)
DOH-1555 (02/2004)