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Hoffis, Patricia a rZ & NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Patricia Hoffis I Female Date of Death Age If Veteran of U.S.Armed Forces, 03/20/2020 85 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death ©Natural Cause ❑Accident Homicide Suicide ❑Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title Abigail Macomber PA Address 100 Park St,Glens Falls,New York 12801 _ Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 132 Ej Burial Date Cemetery,Crematory or Facility Name 03/23/2020 Pine View Crematory Entombment Address X❑Cremation Queensbury Town,New York Donation Removal Date Place Removed and/or and/or Held Hold Address ❑Transportation Date Point of by Common Shipment Carrier Destination u Disinterment Date Cemetery Address a- Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 Address �a== 123 Main St,Argyle,New York 12809 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address W Permission is hereby granted to dispose of the human remains described above as indicated. 03/23/2020 6ert .�;� Date Issued Registrar of Vital Statistics `R9 Andrew Curtis(ECectsonicaQy Signed (signature) District Number 5601 Place Glens Falls, New York <` I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: k}� t Date of Disposition Place of Disposition 9,je -Odress) (section) (lot umb / (grave number) Name of Sexton or Person in Charge of Premi s (please print) Signature Title DO H-1555(o7/18)p 1 of 2 Public Health Law Sec. 4145(2b) 011,152 Receipt Human remains of delivered on " , 20 Pine'View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#, '