Laing, Margaret t 3
NEW YORK STATE DEPARTMENT OF HEALTH 7t 76
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Margaret Helene Laing Female
Date of Death Age If Veteran of U.S. Armed Forces,
03/27/2017 90 years War or Dates
F- Place of Death Hospital, Institution or
taZ City, Ign oxyklme Schenectady Street Address Ellis Hospital
O Manner of Death Natural Cause El Accident El Homicide ❑Suicide ❑Undetermined ❑Pending
W Circumstances Investigation
0.
ul Medical Certifier Name Title
Dr. John Biddenhagen M.d.
Address
1101 Nott Street, Schenectady, Ny 12038
Death Certificate Filed District Number Register Number
City,XXXD(cXX 96ge Schenectady 4601 328
"'Burial Date Cemetery or Crematory
03/29/2017 Pine View Crematnry
❑Entombment Address
v❑Cremation Queensbury, Ny
Date Place Removed
• Removal and/or Held
and/or Address
F Hold
CA
O Date Point of
c Transportation Shipment
0 by Common Destination
Carrier
❑Disinterment Date Cemetery Address
❑Renterment Date Cemetery Address
Permit Issued to Registration Number .
Name of Funeral Home Wilcox & Regan 01821
Address
iiiip 11 Algonkin Street, Ticonderoga, N Y 12883
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
• Address
IE
a" Permission is hereby granted to dispose of the human remains describe above as indicated.
Date Issued 03/28/2017 Registrar of Vital Statistics g'��i,
¢� (shgna-turii)
District Numbe4601 Place Schenectady
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
r
ill• Date of Disposition 3131ii7 Place of Disposition i�,c ir�J irl-m¢foti
2 (address)
LU
CA
CC (section) (lot number) (grave number)
• Name of Sexton or Person in Charge of Premises C f s i , [14 l if
2 (pl ase print)
Signature Zl 1:19', Title 14,1461A-
(over)
DOH-1555 (02/2004)