Watson, Anna tt -73y
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Anna M.Watson Female
Date of Death Age If Veteran of U.S. Armed Forces,
09/06/2018 96 Years War or Dates
l „ Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address The Pines At Glens Falls Center For Nursing&Rehabilitation
Manner of Death 0 Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
Circumstances Investigation
Medical Certifier Name Title
Jean Flanagan MD
Address
170 Warren St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls 5601 424
❑Burial Date Cemetery or Crematory
09/10/2018 Pine View Crematory
['Entombment Address
®Cremation Queensbury Town, New York
Date Place Removed
❑Removal and/or Held
and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
Carrier
❑Disinterment
Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
v. Address
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/07/2018 Registrar of Vital Statistics 6ertACurtis(fE(ectronicalTySigned)
(signature)
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:
Cit Date of Disposition 9 f1, 1 1 Place of Disposition L.
(address)
(section) (lot tuber) (( (grave number)
iName of Sexton or Person in Charge of Premises �if,s '' _) &nalir
(please pr t)
Signature Title I1 %L
(over)
DOH-1555 (02/2004)