Partridge, Peter t. I 31Z
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
11 Name First Middle Last Sex
Peter Michael Partridge Male
Er, Date of Death Age If Veteran of U.S. Armed Forces,
04/15/2018 72 Years War or Dates Army
Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
Manner of Death Natural Cause Accident Homicide D Suicide 0 Undetermined 0 Pending
i Circumstances Investigation
Medical Certifier Name Title
Jean Vanauken PA
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls 5601 186
❑Burial Date Cemetery or Crematory
04/17/2018 Pine View Crematory
❑Entombment Address
®Cremation Queensbury, New York
Date Place Removed
ri Removal and/or Held
and/or Address
Hold
=.r Date Point of
Li Transportation Shipment
by Common Destination
Carrier
Disinterment
Date Cemetery Address
_`Q Reinterment Date Cemetery Address
H +rt Permit Issued to Registration Number
igi Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
_... Address
i=.
t
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/16/2018 Registrar of Vital Statistics qRg6ertACurtis(E(ectronicafySigned)
(signature)
District Number 5601 Place Glens Falls, New York
t I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition y I nil i Place of Disposition C1..,V..._ Pew-L
(address)
0
(section) '(lot number) (grave number)
Name of Sexton or Person in Charge of Premises /r.�tp, �''1`t
(please pith
III 4
Signature
Title M e'p(L-
(over)
DOH-1555(02/2004)