Redmond, Sandra _.,vc.,
NEW YORK STATE DEPARTMENT OF HEALTH Burialira - Transit Permit
Vital Records Section
Name First Middle Last Sex
Sandra A Redmond Female
Date of Death Age If Veteran of U.S.Armed Forces,
. April 16, 2016 70 War or Dates
2 Place of Death Hospital, Institution or
W City,Town,or Village Granville Street Address Haynes House of Hope
o Manner of Death 0 Natural Cause 0 Accident 0 Homicide 0Suicide 0 Undetermined 0 Pending
W Circumstances Investigation
() Medical Certifier Name Title
W Dr. Sean L. Kimball, M.D. Dr.
a Address
Granville Family Health, 79 North Street, Granville, NY 12832
Death Certificate Filed District Number S'T S(v Register Number
City,Town or Village Granville
❑Burial Date Cemetery or Crematory
April 20, 2016 Pineview Crematorium
❑Entombment Address
z Q Cremation 21 Quaker Road Queensbury, NY 12804
Date Place Removed
0 0 Removal and/or Held
and/or Address
Im Hold
-
0 Date Point of
0 0 Transportation Shipment
d by Common Destination
Carrier
Date Cemetery Address
ur Disinterment
t� Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Jillson Funeral Home, Inc. 00885
Address
46 Williams Street, Whitehall, New York 12887
Name of Funeral Firm MakingDisposition or to Whom
2
lY Remains are Shipped, If Other than Above
W Address
0.
Permission is hereby granted to dispose of the human remains described above as indicated.�
Date Issued p 4(l I I ao I6 Registrar of Vital Statistics dd t^^J CuSte-f
(signature)
District Number SI.% Place Granville,New York
F I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
2
W Date of Disposition 04/20/2016 Place of Disposition Pineview Crematorium
2 (address)
W
0
O (section) (lot number) (grave number)
0• Name of Sexton or Pe in arge of Premises -J O,^A-ft 62 -4G.v4,
z
(please print)
Signature Title G r�ma Ito i
(over)
DOH-1555 (02/2 04)