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Catone, Patricia t- 4' it Z 5 NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit err. Name First Middle Last Sex Patricia Ann Catone Female Date of Death Age If Veteran of U.S. Armed Forces, . 03/21/2018 70 Years War or Dates Place of Death Hospital, Institution or City, Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death©Natural Cause 0 Accident 0 Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation et e Medical Certifier Name Title Farhana Kama! MD Address • 100 Park St,Glens Falls,New York 12801 It Death Certificate Filed District Number Register Number --z City, Town or Village Glens Falls 5601 146 R; i' ❑Burial Date Cemetery or Crematory 03/23/2018 Pine View Crematory _❑Entombment Address ®Crematign Queensbury Town, New York Date Place Removed ❑Removal and/or Held and/or Address Hold Date Point of Q Transportation Shipment by Common Destination y(t1. Carrier ate: • Disinterment Date Cemetery Address ,.. El Reinterment Date Cemetery Address y; Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 PiAddress • 11 Lafayette St,Queensbury,New York 12804 j Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above -" Address ,erg Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/23/2018 Registrar of Vital Statistics Wp6ertA Curtis(E(ectronica1TySigned) P (signature) 3'° District Number Place 5601 Glens Falls, New York 34 ',Ai I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 3h2i#lit Place of Disposition g4„.../ c(,,�y`, Viz; (ad Tess) ,Try, (section) d(lot number) (grave number) Name of Sexton or Person in Charge of Premises �, )rAl (pitprint) L Signature �^ Title ffl ►`1TD (over) DOH-1555 (02/2004)