Loading...
McNall, Mildred NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Y.. ' Burial - Transit Permit Name First Middle Last Sex Mildred M. McNall Female Date of Death Age If Vetera f U.S. Armed Forces, June 12, 2018 91 • War ates Place of Death Hospi Institution or us City, Town or Village South Glens Falls Street Address 12 Circle Drive W Manner of Death X❑Natural Cause ElAccident ❑ Homicide 0 Suicide ❑ Undetermined ri❑ Pending U Circumstances Investigation W© Medical Certifier Name Title William A. Tedesco, M.D. Dr. Address 3 Irongate Center Glens Falls, NY 12801 Death Certificate Filed District Number Register Number City, Town or Village South Glens Falls ❑Burial Date Cemetery or Crematory June 18, 2018 Pine View Crematory ❑Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed z ❑ Removal and/or Held • and/or Address E Hold 0 Date Point of fly. ❑Transportation Shipment #J by Common Destination la Carrier "' ❑ Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M.B. Kilmer Funeral Home-SGF 01078 Address 136 Main Street, South Glens Falls NY 12803 Name of Funeral Firm Making Disposition or to Whom . Remains are Shipped, If Other than Above • Address E. Permission is hereby ranted to dispose of the human remai s described above as indicated. Date Issued 0(0 / 020 Registrar of Vital Statistics v (signature) District Number �iSa'� Place ( I Q(� sowoi. Ids ( �(S certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 06/18/2018 Place of Disposition Quaker Road Queensbury,NY 12804 (address) ir (section) //� (lot number) (grave number) to 0Name of Sexton or Person in Charge of Premises hn �J�^ r (please print) W Signature 0 Title ((0144-142 T (over) DOH-1555 (02/2004)