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Spangenberg, Doris NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section 1. Burial - Transit Permit Name First Middle Last Sex Deloris Spangenberg Female Date of Death Age If Veteran of U.S. Armed Forces, R 08/28/2017 89 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 ❑Accident ❑Homicide El Suicide ElUndetermined ❑Pending Circumstances Investigation Medical Certifier Name Title t William Cleaver MD w Address 100 Park St,Glens Falls, New York 12801 ' Death Certificate Filed District Number Register Number City, Town or Village Glens Falls 5601 458 0 Burial Date Cemetery or Crematory 08/30/2017 Pine View Crematory 0Entombment Address k®Cremation Queensbury Town, New York - Date Place Removed ❑Removal and/or Held and/or Address Hold Date Point of dk_Li Transportation Shipment by Common Destination Carrier Li Disinterment Date Cemetery Address 14-,ElReinterment Date Cemetery Address ' Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 -- Address , 24 Church Stpo Box 500, Lake Luzerne, New York 12846 v Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address rri- ra Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/30/2017 Registrar of Vital Statistics [r(96ertAcurtis cECectronicallySigned (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 4131 i n Place of Disposition f„i Li e.�,- to,4-/ i (address) (section) f (lot number) (grave number) t. Name of Sexton or Person in Charge of Pr mises PArat r 3 8144 (pl ase print) Signature Title (Ri!`m - (over) DOH-1555 (02/2004)