Ward, Jean A. NEW YORK STATE DEPARTMENT OF HEALTH
vital RecordsSectimo 4, Burial - Transit Permit
Name Pint MlEdro last Sex
Jean A. Ward Female
Date of Death Age IT Veteran of U.S. MMW Forces,
07 08 20 73 War Dr Oates -----
i- Place of Cards Herpme" Insumti Or
2W Oity. Townor Vll Tow Of Corinth Street Address 200 Dorset Drive
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0 Medical CerNier Name This
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Address
102 Park St . , Glens Falls , NY 12801
Death Caramels Filed Taw Of Corinth DbMct Number g553 Register Number
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[ Burial Date Cemesery or Crematory
❑entombmml OT/Ic/20 PSneviee Crematory
Address
®Cremeban Qu¢enebury, NY
Date Plum Removetl
ZO ❑ Removal eMrar Held
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by Gammon Destrta4on
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�DisiMermeM Date Cemelary Address
Q Performed Dete Cemetery Atltlrles
Permit Issued to R, "Mom Number
Name Of Pursue! Home Densmore Funeral Home, Inc . 0M8
Address
T Sherman Ave, Corinth, NY 12822
Name of weerel Firm If Other
Deposition Ali14m or ro Mom
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I1 PermiWen is hereby granted btllpou el Me bumM I�na therearlbrand! esselt 09lntllmlatl.
Date Issued 07/09/20 RegbtrmWVMl Statletlm `a` LL�a ll I AA^(AI
Dbixt Number 4553 Name Corinth, NY
F I deal that the remains M Me tlecedent identified above We W of in Terminal wMibu p ft an
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on Name of Sexton or Peraan in CM1erg W Premises __ y
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W Signature _ This
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DOH-1556 (0212004
I Nbhc Heath lawSa. 4145(2b) U12503
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