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McBride, Joseph NEW YORK STATE DEPARTMENT OF HEALTH 3`� Vital Records Section Burial - Transit Permit Name First Middle Last Sex Joseph Francis McBride Male Date of Death Age If Veteran of U.S. Armed Forces, 05/07/2016 82 years War or Dates i c] S 3 -- 5S" 1-s Place of Death Hospital, Institution or W City, T�(Xr X,q ( Glens Falls Street Address Glens Falls Hospital 0 Manner of Death Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined El Pending tti Circumstances Investigation la Medical Certifier Name Title CV William Cleaver Attending Physician Address 100 Park St Glens Falls, NY 12801 Death Certificate Filed District Number Register Number City, T X015AX X Glens Falls 5601 245 ['Burial Date Cemetery or Crematory 05/11/2016 Pine View Crematorium r;; 0 Entombment Address ©Cremation Queensbury, NY 12804 Date Place Removed Z❑Removal and/or Held and/or Address Hold tit 0 Date Point of CL ❑Transportation Shipment a by Common Destination Carrier ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Wilcox& Regan Funeral Home 01821 Address 11 Alqonkin Street Ticonderoga, N Y Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above . Address tr. EI fl`` Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/10/2016 Registrar of Vital Statistics (A)cAA.,y-,Q (A)j1.�'( ignature) District Number 5601 Place Glens Falls,N'j 1 I certify that the remains of the decedent identified above were disposed of inaccordance with this permit on: Place of Disposition 1f (� ( Laia— f� Date of Disposition 113'/� p �,� r� (address) VI iZ (section) (lot number) (grave number) Ct Ci Name of Sexton or Person in Charge o Premises �n i 2 lease print) Signature 4 Title C2 �-��2 (over) DOH-1555 (02/2004)