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Blondin, Emelie Marie N EW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Emelie Marie Blondin Female Date of Death Age If Veteran of U.S.Armed Forces, 12/31/2019 80 Years Waror Dates F. Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital V Mannerof Death ©Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation LU G Medical Certifier Name Title Stayci Natterer DO Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 12856 Burial Date Cemetery,Crematory or Facility Name 01/03/2020 Pine View Crematorium Entombment Address Cremation Queensbury Town,New York Donation z Removal Date Place Removed H and/or and/or Held N Hold Address O 0. N Transportation Date Point of p by Common Shipment Carrier Destination ā¯‘Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition orto Whom i.. Remains are Shipped,If Other than Above Address IM W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/02/2020 Registrar of Vital Statistics DanieffeS GilCespie(E(ectronicallySiyned) /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: H Z Date of Disposition z,> Place of Disposition t' W 2 Tess/ W CO) (section) (lot umber/ (grave number/ Name of Sexton or PersoI/Cnh rgeZ /p/easeprint/ Signature G Title 7` DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#