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Reid, MD. Robert NEW YORK STATE DEPARTMENT OF HEALTH f -- e Vital Records Section Burial - Transit Permit Name First Middle Last Sex Robert Allan Reid,MD 1 Male :. Date of Death Age If Veteran of U.S. Armed Forces, August 23,2011 87 War or Dates World War II ZPlace of Death Hospital, Institution or City, Town or Village Glens Falls Street Address Glens Falls Hospital 0.1 ci Manner of Death ifi, Leli Natural Cause Accident I I Homicide E Suicide n Undetermined Pending iii Circumstances Investigation la, Medical Certifier Name Title P.: Paul Backman Dr. Address re 3767 Main Street,Warrensburg,NY 12885 Death Certificate Filed District Number Register Ny ber City, Town or Village Glens Falls 5601 7� ❑Burial Date Cemetery or Crematory ❑Entombment August 24(2011 Pine View Crematorium Address ©Cremation 21 Quaker Road, Queensbury,NY 12804 Date Place Removed ZZ n Removal and/or Held and/or Address H Hold to 0 Date Point of N n Transportation Shipment p by Common Destination Carrier n Disinterment Date Cemetery Address n Renterment Date Cemetery Address I -., Permit Issued to Registration Number :`, Name of Funeral Home Singleton-Healy Funeral Home 1 01596 Address 407 Bay Road,Queensbury,NY 12804 Name of Funeral Firm Making Disposition or to Whom > Remains are Shipped, If Other than Above Address '' Permission is here y granted to dispose of the human remains descr277 as ed. Date Issued 0r a- , / Registrar of Vital Statistics i ► g (signature) District Number 5601 Place Glens Falls /J2(`' / 2/ I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z � /+ W Date of Disposition '-z-i Place of Disposition 1 i,u Ltd 1,wtftel-6<lam-. 2 (address) W co re (section) _`` (lot number— (grave number) p Name of Sexton or Person in Charge of P mises (I — t ist( tr- J t itK t Z !!! (please print) W Signature Title cac mil j il t_ (over) DOH-1555(02/2004)