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Strain, Jean Patricia NEWYORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Jean Patricia Strain Female Date of Death Age I-Iff Veteran of U.S.Armed Forces, 04/26/2020 85 Years War or Dates Place of Death Hospital,Institution or p2 City,Town or Village Fort Edward Village Street Address 4 Center Street, Fort Edward Village, New York 12828 Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending W (� Circumstances Investigation WW Medical Certifier Name Title Anthony Petracca MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Fort Edward 5755 34 ❑Burial Date Cemetery,Crematory or Facility Name 04/28/2020 Pine View Crematory Entombment Address X❑Cremation Queensbury Town,New York ❑Donation Z :t���and�jorHeld ed 0 Removal 1, and/or N Hold Address 0 d Date Point of N Transportation I� by Common Shipment Carrier Destination 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 W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/27/2020 Registrar of Vital Statistics Aimee 9Kahoney(2CectronicaCCy Signed (signature) District Number 5755 Place Fort Edward, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition !/Z$1Z(0PlaceofDisposition ,p'L fL- g, (address) lu N c (section) 12hot number/ (grave number) 8 Name of Sexton or Person in Charge Premises r. J N/ Z (plea print) lu Signature Title C DO H-1555(07/18)p 1 of 2