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MacDonald, June NEWYORK STATE DEPARTMENT OF HEALTH � - Ffl'# Burial - Transit Permit Bureau of Vital Records Name First Middle fast Sex June MacDonald Female Date of Death Age If Veteran of U.S.Armed Forces, 05/09/2020 82 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Hempstead Town Street Address Nassau University Medical Center Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title Natasha Kohanzadeh Address e: 2201 Hempstead Tpke,Hempstead Town,New York 11554 Death Certificate Filed District Number Register Number City,Town or Village Hempstead 2950 Burial Date Cemetery,Crematory or Facility Name 05/14/2020 Pine View Cemetery&Crematorium ❑Entombment Address 21 Cremation Queensbury Hamlet,New York ❑Donation Removal Date Place Removed and/or and/or Held Hold Address Transportation Date Point f by Common Shipr, gin' Carrier Destination p Disinterment Date Cemeter/Address p Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home N F Walker Inc 01234 Address 2039 Merrick Avenue,Merrick Hamlet,New York 11566 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 05/10/2020 Registrar of Vital Statistics KgthCeen Murray(ECectronicady Signer) (signature) District Number 2950 Place Hempstead, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition -Z ZO Place of Disposition C/-t r4,4m (section) (lot num r/ (grace number) Name of Sexton or Person in C arge of Pre ' es r- (lease print) Signature �!` Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) , 013616 1 Receipt Human remains of <- fr'. delivered on 120 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#