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Tilford, Beatrice Elizabeth NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex j Beatrice Elizabeth Tilford Female Date of Death Age If Veteran of U.S.Armed Forces, 03/23/2020 79 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Argyle Town Street Address 31 Holmes Road,Argyle Town, New York 12809 Manner of Death ©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title William Parker MD ary Address 9 Carey Road,Queensbury Town,New York 12804 k Death Certificate Filed District Number Register Number City,Town or Villa a Argyle 5750 13 Date Cemetery,Crematory or Facility Name ❑Burial rY• ry Y 03/25/2020 Pine View Crematory ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation ❑Removal Date Place Removed and/or and/or Held Hold Address ❑Transportation Date Point of jal by Common 77Shipment Carrier Destination 71 ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/24/2020 Registrar of Vital Statistics Shelley Mckgrnon(ECectronicalfy Signed) (signature/ District Number 5750 Place Argyle, New York certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition Zoz Place of Disposition ;,JC I ,e'-j (ad ) (section) l (lot number/ (grave number) Name of Sexton or Person in Charge of remises .dc� Zr, (please print) 17ji Signature Title DOH-1555(o7/18)p 1 of 2 Public Health Law Sec. 4145(2b) l 013 4 6 2 Y Receipt Human remains of delivered on Y F F _ Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# i i I' i