McKittrick, Linda it 577
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
▪ Name First Middle Last Sex
s Linda Mae McKittrick Female
▪ Date of Death Age If Veteran of U.S. Armed Forces,
r ▪ August 6, 2015 68 War or Dates n/a
▪ Place of Death Hospital, Institution or
City, Town or Village Glens Falls, NY Street Address Glens Falls Hospital
tii Manner of Death X Natural Cause Accident I I Homicide Suicide Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
P Michael Miles,MD
Address
100 Park Street,Glens Falls,NY
• Death Certificate Filed District Number Register Number
;;:;' City, Town or Village Glens Falls, NY 5601 3 n
❑Burial Date Cemetery or Crematory
August 12, 2015 Pine View Crematorium
❑Entombment Address
EI Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
F Hold
O Date Point of
u) Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan& Denny Funeral Home 01443
▪ Address
53 Quaker Road, Queensbury, NY 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby g dispose to dis ose of the human remains described above as indicated.
Date Issued S/ 6 l 15 Registrar of Vital Statistics 1"30 n R, kii\l '<ieZi.
(signatur
District Number 560 ) Place 6 ,ti5 .F`CA `` 5 N
Li
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition 1(-1011'Place of Disposition za., r,
W (address)
U)
CL (section) lot number) (grave number)
pName of Sexton or Person in Char a of Premises `v ZZ (pie se print)
Signature Title trzfAitifk
(over)
DOH-1555(02/2004)