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Thornton, John NEW YORK STATE DEPARTMENT OF HEALTH A, iir ZZ Vital Records Section Burial - Transit Permit ini Name First Middle Last Sex John Harold Thornton Male iiiiti Date of Death Age If Veteran of U.S.Armed Forces, 12/20/2016 90 years War or Dates 1945- 1947 Place of Death Hospital, Institution or 5 City, Tg j j gr)(DX( Glens Falls Street Address Glens Falls Hospital Manner of Death©Natural Cause El Accident El Homicide 0 Suicide riUndetermined 0 Pending Circumstances Investigation ig Medical Certifier Name Title William Cleaver Attending Physician Address 100 Park St Glens Falls, NY 12801 Death Certificate Filed District Number Register Number ia City, TOfNCar XIMIX Glens Falls 5601 632 ❑Burial Date Cemetery or Crematory 12/23/2016 Pine View Crematorium ❑Entombment Address [,Cremation Queensbury, NY 12804 Date Place Removed ❑Removal and/or Held and/or I Address Hold th 0 Date Point of EL r—i Transportation Shipment G by Common Destination Carrier Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Compassionate Funeral Care 00364 Address 402 Maple Street Saratoga Springs, NY 12866 iiiiR Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address ir LU Permission is herehy granted to dispose of the human remains described above as indicated. Date Issued 12,2z/2016 Registrar of Vital Statistics // 1 (signature District Number 5601 Place Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 2 lit Date of Disposition 7/2.5/2 Place of Disposition 1/�.w,—e,,.i L re.rvra 4)rc�l / (address)/ tit til CC (section) (lot number) (grave number) CV Name of Sexton or erspn in Charge of Premises J1.4 i'6 "t ✓4e: e e (please print) 41 Signature Title L/e-rn a IL r" (over) DOH-1555 (02/2004)