Loading...
McMurty, Kyle NEW YORK STATE DEPARTMENT OF HEALTH "1 I -.11"1"....114 CZb Vital Records Section Burial - Transit Permit • Name First Midd Last Sex Kyle Patrick McMurty M Date of Death 0 6/2 6/2 01 8 Age 2 3 If Veteran of U.S. Armed Forces, War or Dates Place of Death Hospital, Institution or St. Rt. 9 and Industrial City, Town or Village Warrensburg Street Address Road Manner of Death❑ Natural Cause ® Accident ❑ Homicide ❑ Suicide E Undetermined ❑ Pending Circumstances Investigation rt, Medical Certifier Name Terry M. Comeau Title Coroner Address 1340 State Rt. 9, Lake George, NY 12845 Death Certificate Filed Warrensburg District Number Reis r Number City, Town or Village * -142(e© ❑Burial Date 06/27/2018 Cemetery or Crematory Pine View Crematory ❑Entombment Address OCremation 21 Quaker Road, Queensbury, NY Date Place Removed ❑ Removal and/or Held and/or Address Hold Date 1 Point of ElTransportation ; Shipment by Common Destination Carrier Date Cemetery Address ❑ Disinterment k N., Date Cemetery Address ❑ Reinterment Permit Issued to Registration Number Name of Funeral Home M.B. Kilmer Funeral Home 01078 Address Falls NY 12803 136 Main Street, South Glens , Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is he eby ranted to dispose of the hum- ' - ii ains de ib aboye as indicated. Date Issued cveRegistrar of Vital Stati �� �iu L`� (signature) District Number S206 O Place (1)oi-7L /3 L t�c //IL/osed of in accordance with this permit on:/2-- remains of the decedent identified above werWis I certify that the P Date of Disposition L pi Its Place of Disposition f,,U_., 64, (address) (section) (lot number) (grave number) Name of Sexton or Person in Charge of Premises `Kr (f11L e a5�print) Signature Title (over) DOH-1555 (02/2004)