Loading...
Millis, Rita NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex RITA M. MILLIS FEMALE Date of Death Age If Veteran of U.S.Armed Forces, '` 02/12/2018 73 War or Dates Place of Death Hospital, Institution City ,Town or Village City of Albany or Street Address ALBANY MEDICAL CENTER ❑ Accident ❑ Homicidei ❑ Suicide Manner of Death Natural ❑ Undetermined ❑ Pending �� Cause Circumstances Investigation in Medical Certifier Name Title la DR. JOSHUA SCHULMEN-MARCUS MD Address 43 NEW SCOTLAND AVE ALBANY NY 12208 Death Certificate Filed District Number Register Number City, Town or Village City of Albany 101 0349 Date Cemetery or Crematory ❑ Burial 02/14/2018 PINEVIEW CREMATORY ❑ Entombment Address ®Cremation QUEENSBURY, NY Date Place Removed Z Removal and/or Held © ❑ and/or Address Hold Transportation Date Point of CL p Shipment U) ❑ By Common Destination ©f Carrier El Disinterment Cemetery Address Disinterment Date Cemetery Address ID Reinterment Permit Issued To Registration Number s Name of Funeral Home DENSMORE FUNERAL HOME 00448 Address 7 SHERMAN AVE., CORINTH NY 12822 1 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address =.rt„1 Permission is hereby granted to dispose of the human remains described above as indicated. Date 02/13/2018 Issued Registrar of Vital Statistics -- s (signature) District Number 101 Place City of Albany, NY I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z I Date of Disposition .f I S]1 )j Place of Disposition p Ito-t; cit., C rt ci•lo r y L (address) Lu co ce (section) (lot number) (grave number) g W Name of Sexton or Person in Charge of Premises 3(M-cd" 5 L' r�� (please print) Signature /�j' _i1 f Title C(Q.'LIGr �- (over) DOH-1555 (02/2004)