Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Dupuis, Willaim F.
31L NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex William F.Dupuis Male Date of Death Age If Veteran of U.S.Armed Forces, 04/03/2020 72 Years War or Dates Vietnam Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death W Natural Cause FlAccident Homicide ❑Suicide Undetermined Pending V Circumstances Investigation QMedical Certifier Name Title Dean Reali DO Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 161 Burial Date Cemetery,Crematory or Facility Name 04/07/2020 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York ❑Donation Z Date Place Removed 0 Removal and/or and/or Held F_rn Hold Address O (L Date Point of (nFlTransportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address u1 d Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/06/2020 Registrar of Vital Statistics Rg6ertAndrew Curtis(ECectronica!lySiyned) (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: F- Z Date of Disposition Z,V Place of Disposition , futi W 2 (address/ UJ N X (section) (lot number) (grave number) aName of Sexton or Person in Charge of Premises4 L 1..�►f z (plea print) W �r Signature Title DO H-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 013512 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#