DeLong, Marlene-� G61
r
Burial - Transit Permit
NEWYORK STATE DEPARTMENT OF HEALTH
Bureau of Vital Records
Middle Last
Sex
Female
Name First
Marlene Margaret DeLong
U.S. Armed Forces,
Date of Death
Age
TifVeteranof
10/09/2019
67 YearsWar
or Dates
F,
Place of Death
�Hospital, Institution or
ddress Glens Falls
Hospital
Z
City, Town or Village Glens Falls
Accident � Homicide � Suicide
Undetermined Pending
Investigation
pElMannerof
Death Natural Cause
X
Circumstances
Medical Certifier Name Title
David Cunningham MD
Address
100 Park St, Glens Falls, New York 12801 r Number
Death Certificate Filed ��56�01
mber
City, Town or Village Glens Falls
Burial Date Cemetery, Crematory or Facility NameEl —
10/11/2019 Pine View Crematory
Entombment Address
Lai Cremation Queensbury, New York
Donation
Date Place Removed
Removal and/or Held
and/or
Hold Address
Date Point of
Transportation Shipment
by Common
Carrier Destination
Date Cemetery Address
Disinterment
Date Cemetery Address
Reinterment
Registration Number
Permit Issued to
Regan & Denny1444
Name of Funeral Home y Funeral Service
Address
94 Saratoga Ave, S Glens Falls, New York 12804
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 10/10/2019 Registrar of Vital Statistics Ryden,,IdrewCurtu'(Ekctramca.TySy-ea)
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:
Date of Disposition 1G I c� Place of Disposition P f`e� i Gw i z"I
Ladd;
Name of Sexton or Person in Charge of Premises
Signature
Title GfvMg }a r
DOH-1555 (OA118) p 1 of 2
Public Health Law Sec. 4145(2b) , 012593
Receipt
Human remains of '{ ��' ' delivered on �A , 20 ' t
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg. or License #� } -; —