McGuirk, Louise Marie �R
NEW YORKSTATE DEPARTMENT OF HEALTH � 703
Burial - Transit Permit
Bureau of Vital Records
Name First Middle last Sex
Louise Marie McGuirk Female
Date of Death Age If Veteran of U.S.Armed Forces,
03/02/2020 62 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Vitlage Glens Falls Street Address 184 Ridge Street,Glens Falls, New York 12801
W
p Mannerof Death r�-0;1 Natural Cause Accident Homicide Suicide Undetermined Pending
W Circumstances Investigation
U
W Medical Certifier Name Title
0 Lisa Armao NP
Address
319 South Manning Boulevard 301,Albany,New York 12208
Death Certificate Filed District Number Register Number
City,Town or Village Glens Falls 5601 109
Burial Date Cemetery,Crematory or Facility Name
03/09/2020 Pine View Crematory
Entombment Address —
RCremation Queensbury Town,New York
Donation
Z Removal Date Place Removed
and/or and/or Held
�- Hold Address
N
O
a Date Point of
N Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
F.. Remains are Shipped,If Other than Above
Address
CC
W
IL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 03/05/2020 Registrar of Vital Statistics !R-o6ertgndrewCurtu(Ekctron-alySyne4
(signature)
District Number 5601 Place Glens Falls, New York
Iify that the remains of the decedent identified above were disposed of in accordance with this permit on:
of Disposition )`10`lp� Place of Disposition
a dress)
(section) (lot number) (grave number)
e of Sexton or Person in Charge of Premises J 2 rrM1'I LyJ (pleaseprint)
ature Title `e.w► r
DO H-1555(o7/18)p 1 of 2
Public Health Law Sec. 4145(2b) YJ �-
Receipt
Human remains of - delivered on , 20_.•
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#