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Granger,Lisa Marie
- 311 NEWYORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Lisa Marie Granger Female Date of Death Age If Veteran of U.S.Armed Forces, 04/02/2020 47 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending W() Circumstances Investigation QW Medical Certifier Name Title Rita All NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 158 ❑Burial Date Cemetery,Crematory or Facility Name Q 04/06/2020 Pine View Crematorium Entombment Address Cremation Queensbury Town,New York Donation ZO Removal Date Place Removed and/or and/or Held H N Hold Address d 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 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 Otherthan Above 2 Address M W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/06/2020 Registrar of Vital Statistics WpbertAndrew Curtis(ECectronicaCly 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: H " Z Date of Disposition 17.6 Place of Disposition IL 1 I Lu 2 /address/ w rn M (section) ot number/ /grave number/ on Name of Sexton or Person in Charge of Premises Ajt',-,4L3�11 rr Z ' (plea a print) W Signature t Title filfJo m DOH-1555(07/18)p t of 2 Public Health Law Sec. 4145(2b) 1 5 0 6 � Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# % ' 1;,1"7