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Sharrow, Francis S NEW YORK STATE DEPARTMEN1 OF HEALTH; �� Vital Records Section ` Burial - Transit Permit • Name First Middle Last Sex Francis H Sharrow Male Date of Death Age If Veteran of U.S.Armed Forces, • 07/01/2018 82 Years War or Dates Place of Death Hospital, Institution or City, Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death©Natural Cause ❑Accident 0 Homicide ❑Suicide ri❑Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title a Abigail Macomber PA Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City, Town or Village Glens Falls 5601 323 k ❑Burial Date Cemetery or Crematory 07/03/2018 Pine View Crematory ❑Entombment Address ®Cremation Queensbury, New York a ,_ Date Place Removed ❑Removal and/or Held and/or Address Hold e 0 Date Point of ❑Transportation Shipment by Common Destination -- Carrier_ ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address ;t Permit Issued to Registration Number -- Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 er Address • 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/03/2018 Registrar of Vital Statistics p6ertA Curtis(E(ectronica1Ty Signed) (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: 1,11 Date of Disposition 1)5 n.0 �1$ Place of Disposition j'h ,�T�,`-. y (address) N ix (section) (lot numb i ,, (grave number) aName of Sexton or Person i Charge of P mises /"n J�'"� Z (please print WI Signature Title febbtRit (over) DOH-1555(02/2004)