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McFarren Sr., Alan i ; /ea NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit f ;. Name First Middle Last Sex Alan L.McFarren Sr Male OP Date of Death Age If Veteran of U.S. Armed Forces, c 12/26/2017 68 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 El Accident 0 Homicide ❑Suicide El Undetermined El Pending Circumstances Investigation Tfl Medical Certifier Name Title Sean Bain MD 071 .F Address fti 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number cA City, Town or Village Glens Falls 5601 672 pA❑Burial Date Cemetery or Crematory 12/28/2017 Pine View Creamatory fti❑Entombment Address viA®Cremation Queensbury, New York 171 Date Place Removed • Removal and/or Held and/or Address Hold Date Point of Transportation Shipment by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number • Name of Funeral Home Jillson Funeral Home Inc 00885 Address 46 Williams Street,Whitehall Village,New York 12887 em • Name of Funeral Firm Making Disposition or to Whom *r Remains are Shipped, If Other than Above Address rni Permission is hereby granted to dispose of the human remains described above as indicated. • Date Issued 12/27/2017 Registrar of Vital Statistics RRg6ert A Curtis ElectronicalfySigned (signature) <,- District Number 5601 Place Glens Falls, New York tti I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: io Date of Disposition f2/29'//7 Place of Disposition ?/Y7wi e_ce.444 k (address) n1 (section) i (lot nu ber) (grave number) Name of Sexton or P r n in harge of Premises c.Jv )`�4't &4 e (please print) <x,b Signature Title GfP-Y'-1 (over) DOH-1555 (02/2004)