Marcy, Joy Stifc
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section , . Burial - Transit Permit
Name First Middle Last Sex
Joy A. Marcy Female
Date of Death Age If Veteran of U.S. Armed Forces,
July 17, 2015 93 War or Dates
Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
gManner of Death X Natural Cause Accident Homicide Suicide Undetermined Pending
�f Circumstances Investigation
Medical Certifier Name Title
gi Michael Miles MD
Address
100 Park St. Glens Falls,NY
Death Certificate Filed District Number Re er N tuber
City, Town or Village b '
❑Burial Date Cemetery or Crematory
❑Entombment July 21, 2015 Pine View Crematorium
Address
0 Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
H Hold
CO
O 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 Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Road, Queensbury,NY 12804
: Name of Funeral Firm Making Disposition or to Whom
IRemains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human a ains described a ove as i . •d.
Date Issued O)/ AD Registrar of Vital Statistics ai.g n DIV
'.°� s' at )
District Number 36,0 / Place c‹_i few /'
I certify that the remains of the decedent identified above were disposed of in accordance w' h this permit on:
I—
wDate of Disposition '.)-.2c•-•—.206 Place of Disposition ' e kl,,"eei/ C•re.M -kurt:Jin
W (address)
U)
0 (section) 0 (lot Timber) (grave number)
pName of Sexton or `Person in harge of Premises 1 (`wlo�-k 4)('vne(K
Z �—_I��-✓`s,l (please print)
LU 1 Are Signature Title C fir, �ot"y
(over)
DOH-1555(02/2004)