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Bradley, Kathleen Rose NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Kathleen Rose Bradley Female Date of Death Age If Veteran of U.S.Armed Forces, 11/26/2019 65 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Albany Street Address Albany Medical Center Hospital G Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined ❑Pending W Circumstances Investigation 1�I Medical Certifier Name Title Sean Geary MD Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 2553 ❑Burial Date Cemetery,Crematory or Facility Name 11/29/2019 Pine View Crer,tato v Entombment Address X❑Cremation Queensbury Town,New York Donation z El Removal Date Place Removed and/or and/or Held F-as Hold Address O IL Date Point of ❑Transportation Shipment Ll by Common Carrier Destination ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom F Remains are Shipped,If Other than Above Address 'EC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/27/2019 Registrar of Vital Statistics lnanieCCe S GiCCespie(ECectronicalTySigned) (signature) District Number 0101 Place Albany, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition 11 ,7,11IS Place of Disposition ./ 401"— Uj (address/ W (section) (lot number (grave number/ Name of Sexton or Person in Charge of P mises �1,'WL' I—Al"W Z (please print) tU Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 0 1 10 Receipt Human remains ofN delivered on ` , 20_ Pine View Cemetery Representing the funeral home named on burial_permit Official Funeral Directors Reg.or License#