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Battease, Sherry NEW YORK STATE DEPARTMENT OF HEALTH ' - r # 7°7 Vital Records Section Burial - Transit Permit Name First Middle iie st Sex Sherry Jean Batte e _ Female Date of Death Age If S. Armed Forces, December 18, 2016 54 i=te Place of Death Hos• . ution or City, Town or Village Hudson Falls Street 120 B John Street ..' Manner of Death Natural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined ❑ Pending ,.r Circumstances Investigation a Medical Certifier Name Title CM 'US luf\VD Address IOZ _Vo S r e 3 '1`QI\S t o \'s P\1 1 L.&v Death Certificate Filed District Number Register Number City, Town or Village Hudson Falls S -7 G 3 -, ❑Burial Date \Z _ o emetery or Crem Cory UJ �n Pine Viewrrematory R ❑Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed ❑ Removal and/or Held and/or Address Hold Date Point of -0 Transportation Shipment by Common Destination Carrier ❑ Disinterment Date Cemetery Address 3'❑ Reinterment Date Cemetery Address Permit Issued to Renistration Number `-, Name of Funeral Home M. B. Kilmer Funeral Home-Argyle OtC57Q Address Name of Funeral Firm 'Making Disposition or to Whom Remains are Shipped, If Other than Above Address r. s Lit _ Permission is hereby granted to dispose of the human remains described above as indicated. - Date Issued b-p-t)i-te 4, Registrar of Vital Statistics itkc� i 64-4-TA-k_ ® (signature) District Number 5 73-4, Place /,, / ia�{ U-Is Mid„ '`*•# �Q 1/S .w 4 M I certify that the remains of the decedent identified above were ,: 1 i,e ccordance with this permit on: Date of Disposition/2/2/ /6, Place of Disposition Quaker -'•ad Queensbury,NY 12804 P7,14),?„,.4/6/z ;;1ci,x (address) (section) (lot number) (grave number) Name of Sexton or a on . Charge of Premises J / :0 ''1 Gi''" a4e, (please print) Signature /^. Title C fCa (over) DOH-1555 (02/2004)