Didio, Carmella NEW YORK STATE DEPARTMENT OF HEAL' + * �,
Vital Records Section Burial - Transit Permit
Name First Addle Last Sex
Carmella T. Didio Female
Date of Death Age If Veteran of U.S. Armed Forces,
January 20, 2011 88 War or Dates
} Place of Death Hospital, Institution or
Z City, Town or Village Glens Falls Street Address Glens Falls Hospital
,p Manner of Death [XI Natural Cause Accident Homicide Suicide Undetermined Pending
bi Circumstances Investigation
u' Medical Certifier Name Title
. Joseph Mihindu,MD
Address
Glens Falls,NY
Death Certificate Filed District Number Register Number
' City, Town or Village Glens Falls,NY 5601 3 i
❑Burial Date Cemetery or Crematory
January 24, 2011 Pine View Crematory
❑Entombment Address
❑x Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
H Hold
N
O Date Point of
NI 1 Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Singleton - Healy Funeral Home 01622
Address
407 Bay Road, Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
`l Remains are Shipped, If Other than Above
3 Address
tti
v.▪ Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued I 1 21 / I) Registrar of Vital Statistics CL,1,�-,..c
(signature)
District Number 5601 Place Glens Falls,NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition .fHNtI,t?oil Place of Disposition �,nAj,r� Cfbr4Cfosw,..
W (address)
N
re
(section) pet-number) (grave number)
QName of Sexton or Person in Charge of Premises t,s}orik r 'tn
Z , (please print)
Signature Title CRCMpaO2
(over)
DOH-1555(02/2004)