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Santasier, Loretta 3 � ORK STATE DEPARTMENT OF HEALTH ecords Section Burial - Transit Permit ,ame First Middle . Last Sex Loretta A. Santasier Female Date of Death Age If Veteran of U.S. Armed Forces, May 23,2016 61 War or Dates ,., Place of Death Hospital, Institution or City, Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death I x I Natural Cause I I Accident n Homicide Suicide Undetermined Pending l; Circumstances Investigation u.s Medical Certifier Name Title '0", Eric Pillemer MD Address CR Wood Cancer Center,Glens Falls,NY 12801 Death Certificate Filed District Number Register Number City, Town or Village C/O Glens Falls,NY 5601 .26 0 ❑Burial Date Cemetery or Crematory May 25,2016 Pine View Crematory El Entombment Address ©Cremation 21 Quaker Rd., Queensbury, NY 12804 Date Place Removed ZO I ]Removal and/or Held and/or Address H Hold U) 0 Date Point of NTransportation Shipment p by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander-Baker Funeral Home 00037 I Address 3809 Main Street, Warrensburg,NY 12885 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above ,a' Address lit D. Permission is hereby granted to dispose of the human remains des ii ed ab ve in icated. Date Issued OS2Y/z616 Registrar of Vital Statistics /� %� r �` / (signature) District Number c5 66/ Place C AA. /1/2/ I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z £.91/ f� Date of Disposition ���`�/;� Place of Disposition i ,�Cc (address W U) (Y Gg (section) r -(Iqt number (grave number) Name of Sexton or Person in Charge of Premises / ,v�. Z please print) W Signatureii Title / 1 b-1Y/L (over) DOH-1555 (02/2004)