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Durkee, Cheryl NEW YORK STATE DEPARTMENT Vital Records Section Burial - Transit Permit Name First Last Sex Cheryl Durkee Female Date of Death If Veteran of U.S. Armed Forces, November 25, 2018 71 War or Dates Place of Death Hospital, Institution or City, Town or Village Argyle Street Address 4083 State Route 40 i Manner of Death Natural Cause 0 Accident 0 Homicide 0 Suicide U. 0 Undetermined 0 Pending Circumstances Investigation Medical Certifier Name Title M Rodney L. Ying, M.D. Dr. Address 59 Myrtle Avenue Saratoga Springs, NY 12866 Death Certificate Filed District Number Register Number City, Town or Village Argyle 5150 LS 6 0 Burial Date Cemetery or Crematory November 27, 2018 Pine View Crematory 0 Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed Removal and/or Held 1. and/or Address Hold Date Point of fit ❑Transportation Shipment by Common Destination a Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M. B. Kilmer Funeral Home-Argyle 01077 Address 123 Main St., Argyle NY 12809 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address -: s W 1, Permission is hereby granted to dispose of the human re \ins.described ,,�above as indicated. Date Issued i g).l )t Y Registrar of Vital Statistics rr -�`C�' v" ..klAr`"", (signature) District Number 5i50 Place 4 k , iJy I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 11/27/2018 Place of Disposition Quaker Road Queensbury,NY 12804 pi,,,t,v,;,4., ( efrici-lcr/ (address) ill a (section) (lot number) (grave number) 0 1. Name of Sexton or Person in Charge of Premises ��lw.e,/ ,Vi,),ar-Gs (please print) Signature Title tiriLr'i,-Jor (over) DOH-1555 (02/2004)