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Murphy, DonaldNEW YORKSTATE DEPARTMENT OF HEALTH Bureau of Vital Records 43 Burial - Transit Permit Name First Middle Donald Lee Murphy Last 7Ma xDate of Death Age �Iferan of U.S. Armed Forces, e 10/21/2019 76 Years ror Dates 1963-1966 Place of Death City, Town or Village Argyle Town Hospital, Institution or gy Street Address Washington Center For Rehabilitation And Healthcare Manner of Death © ❑ Natural Cause Accident Homicide Undetermined Suicide E] Pending Medical Certifier Name Circumstances Investigation Edit Masaba Title MD Address 4573 State Route 40, Argyle Town, New York 12809 Death Certificate Filed D7srtrict Number Register Number City, Town or Village Argyle I I Date Burial Cemetery, Crematory or Facility Name 10/23/2019 Pine View Crematory Fj Entombment -- ---- A dress — Cremation Queensbury Town, New York Donation 0 Removal Date Place Removed — N and/or and/or Held N Hold Address.- O CL N Transportation Date Point of by Common Shipment Carrier Destination Disinterment Date Cemetery Address EjReinterment Date Cemetery Address Permit Issued to Name of Funeral Home M B Kilmer Funeral Home - South Glens Falls Registration Number Address 01078 136 Main St, S Glens Falls, New York 12803 Name of Funeral Firm Making Disposition or to Whom f- Remains are Shipped, If Other than Above Address W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 1012212019 Registrar of Vital Statistics Shelley Mckernon (Electronically Signed) (signature) District Number 5750 Place Argyle, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date ofDiWsifion Place of Disposition bN (ram, 2 ..1012416 (address) W /section/ /lot number/ (grave number/ gName of Sexton or Person in Charge of Premises Z (p ase print) W $ature Title Cn m DOH-`r 7n8) p lof t Public Health Law Sec. 4145(2b) .;1301 i Receipt Human remains of t �.���' �� delivered on C, Pine View Cemetery Official Representing the funeral home named on Funeral Directors Reg. or License #-t-00 ,20