Bovee, Albert NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Albert Ernest E3ovee Male
Date of Death Age If Veteran of U.S. Armed Forces,
2/1 3/2 01 6 79 War or Dates
-- Place of Death Hospital, Institution or
City, tawn-o Village- Glens Falls Street Address Glens Falls Hospital
IliCt. Manner of Death Natural Cause 0 Accident Homicide Suicide Undetermined Pending
i.. Circumstances Investigation
Ili Medical Certifier Name Title
Nawed Siddiqui Mt)
Address
100 Park Street Glens Falls, NY 12801
Death Certificate Filed District Number Register Number
El City, i—Village Glens Falls ,01 7L
0Burial Date Cemetery or Crematory
02/16/2016 Pine View Crematory
. ;; ❑Entombment Address
®Cremation 21 Quaker Road Queensbury, NY 12804
Date Place Removed
t ❑Removal and/or Held
and/or
F Address
CA
O Date Point of
5 n Transportation Shipment
0 by Common Destination
gE Carrier
El Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M.B. Kilmer Funeral Home 0T078
Address
136 Main Street Aouth Glens Falls, NY 12803
Name of Funeral Firm Making Disposition or to Whom
• Remains are Shipped, If Other than Above •
• Address
tr
iu
Permission is hereby granted to dispose of the human remains descr'bgd abov ,as i c ted.
Date Issued 2- 19 , Registrar of Vital Statistics 1�4/ ��
(signet re)
RE District Number 51601 Place
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ttl Date of Disposition i._f, a, Place of Disposition (a4 -1 a'"'ete`+ --
W (address)
CA
CC (section) ,-(lot numb (grave number)
0 Name of Sexton or Person in Charge of remises ^«
lease print)
tIii
Signature a Title r 6l674—.
(over)
DOH-1555 (02/2004)