Townsend, Margaret if
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NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Margaret M. Townsend Female
Date of Death Age If Veteran of U.S. Armed Forces,
03/18/2018 85 yrs. War or Dates No
Place of Death Town o f Hospital, Institution or
r'"1 City, Town or Village Ti cnndPrnga Street Address 28 Amherst Avenue
Manner of Death 0 Natural Cause Accident D Homicide El Suicide riUndetermined ri Pending
14 Circumstances Investigation
tril Medical Certifier Name Title
CI C. Francis Varga M.D.
Address
P .O. Box 768, Lake P1arid, NY 12946
Death Certificate Filed Town of District Number Register Number
City, Town or Village Ti c_nnr3Prnry 1 564 12
Burial Date Cemetery or Crematory
QEntombment 03/26/201 • Pine View Cr Crematory
Address
®Cremation Queensbury, New York
Date Place Removed
r''❑Removal - and/or Held
r�
and/or Address
d Hold
Date Point of
Q Transportation Shipment
by Common Destination
0.
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Wilcox & Regan funeral home 01 821
Address
11 Algotikin St. , Ticonderoga, New York 17RR3
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
i--1 Address
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rai
Permission is hereby granted to dispose of the human re 'ins descri ed aboo as indicated.
Date Issued 3/2 3/2 018 Registrar of Vital Statistics (� J 13 -1�' e l: /A
(signature
District Number ice°q Place or1„/ „ rapL CCJJ
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
1
i Date of Disposition .5`-Z y-t Place of Disposition p;nty tiol C,rt,r,v4e,cy
lz- (address)
`rr
r7
r (section) (lot number) (grave number)
R. Name of Sexton or Person in Charge of Premises rA y SZIA^US
(please print)
`r ig Signature Title C-ifc,r+4t7 r
(over)
DOH-1555 (02/2004)