Valenti, Frank r 78
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle Last Sex
FRANK ANTHONY VALENTI MALE
Date of Death Age If Veteran of U.S.Armed Forces,
10/26/2016 73 War or Dates
l— Place of Death Hospital, Institution
Z City ,Town or Village City of Albany or Street Address ALBANY MEDICAL CENTER
O Manner of Death ® Natural ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined ❑ Pending
�{ Cause Circumstances Investigation
W.
Medical Certifier Name Title
Q PRAJESH M. GHITAING MD
Address
43 NE SCOTLAND AVE., ALBANY NY 12208
Death Certificate Filed District Number Register Number
City,Town or Village City of Albany 101 2233
Date Cemetery or Crematory
❑ Burial 10/31/2016 PINE VIEW CREMATORIUM
❑ Entombment Address
® Cremation QUEENSBURY, NY
Date Place Removed
Z Removal and/or Held
O ❑ and/or Address
I- Hold
N
a
DatePoint
Transportation Shipment
V) El By Common
p Carrier Destination
El Disinterment
Cemetery Address
Disinterment
Date Cemetery Address
❑
Reinterment
Permit Issued To Registration Number
Name of Funeral Home REGAN DENNY STAFFORD FH 01443
Address
53 QUAKER RD QUEENSBURY NY 12804
Name of Funeral Firm Making Disposition or to Whom
}_
Remains are Shipped, If Other than Above
Address
W
CL Permission is hereby granted to dispose of the human remains descry ed above as indicated.�^
Date 10/28/2016 Registrar of Vital Statistics yv L11 <};f t�t;9.
Issued (signature)
District Number 101 Place City of Albany, NY
I certify that the remains of the decedent identified above were disposed of in accordancece� t�
with this permit on:
Date of Disposition I//Z1/i. Place of Disposition `1�r � '4^"^01-00--
W (address)
2
UI
u)
rY (section) lot number) (grave number)
OCi
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Z Name of Sexton or Person in Charge of Premises G c Selo/4-
w (please print)
Signature ZI Title f CPA&'
(over)
DOH-1555(02/2004)