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Lozada, Dahlia N EW YO RK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Dahlia Lozada Female Date of Death Age If Veteran of U.S.Armed Forces, 04/16/2020 73 Years War or Dates II... Place of Death Hospital,Institution or Z City,Town or Village Hempstead Town Street Address Mount Sinai South Nassau pManner of Death © Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation Q Medical Certifier Name Title Alvin Holcomb MD Address 1 Healthy Way,Hempstead Town, New York 11572 Death Certificate Filed District Number Register Number City,Town or Village Hempstead 2950 02244 Burial Date Cemetery,Crematory or Facility Name Entombment 4, 2020 Pineview Cremtory Address Cremation Queensbury, New York Donation zRemoval Date Place Removed and/or and/or Held N Hold Address a. Date Point of W ❑Transportation by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Macken Mortuary 01088 Address 3930 Long Beach Road, Island Park Village,New York 11558 Name of Funeral Firm Making Disposition or to Whom F Remains are Shipped,If Other than Above Address W IL Permission is hereby granted to dispose of the human remains described above as indicated, Date Issued 05/02/2020 Registrar of Vital Statistics Kgthleen Murray(ECectronicaCfy Signed (signature/ District Number 2950 Place Hempstead, New York I certify that the remains of the decedent identified above were dis sed of in accordance with this permit on: Z Date of Disposition S-3--20 20 Place of Dispositionku (address/ 1iJ coon/ (lot number) // (grave number) Name of Sexton or Person' h of miles in.. Z, (Please print) ttt Signature Title �77/r d DOH-1555(07/18)p 1 of z Public Health Law Sec"4145{2b) 13 71.3 Receipt Human remains of '' delivered on , 20 1 Pine View Cemetery r Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#