Ward, Joyce NEW YORK STATE DEPARTMENT OF HEALTH �
Vital Records Section Burial - Transit Peg Olt
Name First Middle Last Sex
Joyce O.Ward Female
Date of Death Age If Veteran of U.S.Armed Forces,
08/29/2018 96 Years War or Dates
L. Place of Death Hospital, Institution or
To City, Town or Village Fort Edward Town Street Address Fort Hudson Nursing Center Inc
Manner of Death E Natural Cause 0 Accident 0 Homicide D Suicide ri Undetermined ri Pending
TE
Circumstances Investigation
Medical Certifier Name Title
rii Philip Gara MD
Address
4 319 Broadway,Fort Edward Town,New York 12828
Death Certificate Filed District Number Register Number
City, Town or Village Fort Edward 5755 49
❑Burial Date Cemetery or Crematory
08/30/2018 Pine View Crematory
El Entombment Address
NCremation Queensbury Town, New York
Date Place Removed
Removal and/or Held
and/or Address
Hold
c. Date Point of
'74Q Transportation Shipment
by Common Destination
• Carrier
Disinterment Date Cemetery Address
Reinterment
Date Cemetery Address
FA Permit Issued to Registration Number
21 Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077
frk Address
• 123 Main St,Argyle,New York 12809
• Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
8
Permission is hereby granted to dispose of the human remains described above as indicated.
• Date Issued 08/29/2018 Registrar of Vital Statistics Aimee Mahoney Wectronica1CySigned)
(signature)
rn District Number 5755 Place Fort Edward, New York
certify that the remains of the decedent identified above were disposed of in accordance withthis permit on:
• Date of Disposition q 14 i,d Place of Disposition tad truce}•
(address)
77.1
rxj (section) (lot number(ryaia'
((grave number)
Name of Sexton or Person in Charge of Pre ises � +e'} JO14*
(please print)
iii Signature 6 Title C
(over)
DOH-1555 (02/2004)