Turula, Allen F
I/ yo 2
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Allen Alfred Turula Male
.:, Date of Death Age If Veteran of U.S. Armed Forces,
May 22,2017 90 War or Dates World War H
Place of Death Hospital, Institution or
}v City, Town or Village Glens Falls Street Address Glens Falls Hospital
Manner of Death ❑X Natural Cause Accident n Homicide n Suicide ❑Undetermined Pending
Circumstances Investigation
, Medical Certifier Name Title
Susanne Rayeski
Address
100 Park Street,Warrensburg,NY 12885
Death Certificate Filed District Number Register Number
la City, Town or Village Glens Falls 5601 2-S LI
❑Burial Date Cemetery or Crematory
❑Entombment May 25, 2017 Pine View Crematorium
Address
❑x Cremation 51 Quaker Road, Queensbury, NY 12804
Date Place Removed
Z n Removal and/or Held
and/or Address
H Hold
O Date Point of
co n Transportation Shipment
p by Common Destination
Carrier
n Disinterment Date Cemetery Address
n Reinterment Date Cemetery Address
Permit Issued to Registration Number
4Name of Funeral Home Regan Denny Stafford Funeral Home 01443
„ Address
f 53 Quaker Road, Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
, Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human remains
�described above aas iindicated.
Date Issued 5 f Z 1l i -7 Registrar of Vital Statistics P , �c-"'1 ' ".4l1" (sig ature)
•
P District Number 5601 Place Glens Fall t\l V
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
Date of Disposition 5/2S J n Place of Disposition , ,,,,i erirm d,. -
W (address)
N
re
(section) C ,.,� (lot number) (grave number)
0p Name of Sexton or Person in Charge of Premises _ d ,n '
Z (f ase print)
Lt.! /,Signature C,( 1.___ Title 1;41}CPiL
(over)
DOH-1555(02/2004)