Hoskins, Marion Jean � . 83�
NEWYORK STATE DEPARTMENT OF HEALTH BUriat - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Marion Jean Hoskins Female
Date of Death Age If Veteran of U.S.Armed Forces,
12/14/2019 92 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare
p Manner of Death RI Natural Cause Accident Homicide 0 Suicide Undetermined Pending
W Circumstances Investigation
U
W Medical Certifier Name Title
Leonard Gelman MD
Address
4573 State Route 40,Argyle Town,New York 12809
Death Certificate Filed District Number register Number
City,Town or Village Argyle 5750
Burial Date Cemetery,Crematory or Facility Name
12/17/2019 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
z Removal Date Place Removed
and/or and/or Held
r�
Hold Address
O
IL Date Point of
W ❑Transportation Shipment
p by Common
Carrier Destination
ElDisinterment Date Cemetery Address
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077
Address
123 Main St,Argyle,New York 12809
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped,If Other than Above
Address
Q
W
n' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/17/2019 Registrar of Vital Statistics SlrelYMlkl-"-(Electronrcaf Srgrud)
(signature/
District Number 5750 Place Argyle, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H
Z Date of Disposition I-L Place of Disposition YU ^'
LU /address/
W
N (section/Premises �TAWL'otnumber/ lgra ve number/
Q
Name of Sexton or Person in Charge of
S /J/// /ple a print/
LU Signature Z
Title
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) 0 13-1-5 q
Receipt
Human remains of t ' ' ' a delivered on '' t , 20 L
Pine View Cemetery Representing the.funeral home named on burial permit
Official Funeral Directors Reg.or License#