Craw, Elizabeth NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Elizabeth Ann Craw Female
Date of Death Age If Veteran of U.S. Armed Forces,
03/29/2018 92 years War or Dates _
;1 Place of Death Hospital, Institution or
W City, To i V A x Glens Falls Street Address Park St Glens Falls, N Y 12801
lit
• Manner of Death Q+Natural Cause 0 Accident Q Homicide Suicide Undetermined Pending
Circumstances Investigation
ill Medical Certifier Name Title
O Christopher D. Hoy M. D.
Add1rbl uarey Road Queensbury, NY 12804
Death Certificate Filed District Number Register Number
« City, Tam%up Glens Falls 5601 161
Burial Date Cemetery or Crematory
04/02/2018 Pine View Cematory
❑Entombment Address
['Cremation Queensbur j, Ny
Date Place Removed
Z▪❑Removal and/or Held
and/or Address
lH Hold
r
d Date Point of
A`11 Transportation Shipment
d by Common Destination
Carrier
Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M. B. Kilmer Funeral Home 01078
Address
136 Main Street South Glens Falls, N Y 12803
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
#x -
LEE
fl' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/02/2018 Registrar of Vital Statistics (.../J '
(signature)
District Number 5601 Place Glens Falls iv' U
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z.
lii Date of Disposition 1113 II g Place of Disposition e4 i_- t`TMc "4.—
(address)
LEE
C (section) (lot number) (grave number)
ta Name of Sexton or Person in Charge of Premises A+: i.�- �""'4
(p/base print)
Signature
Title AvA nnt
(over)
DOH-1555 (02/2004)