McNeill, Walter NEW YORK STATE DEPARTMENT OF HEALTH '" 17(
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Walter G. McNeill M
Date of Death 04/10/2015 Age 76 If Veteran of U.S. Armed Forces, 1958-61
War or Dates
Place of Death Hadley Hospital, Institution or 49 StonyCreek Road
City, Town or Village y Street Address
'' Manner of Death2Lu NNatural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined 1-7 Pending
Circumstances Investigation
Medical Certifier Name David Foote Title Mp
Address 340 Main Street, Hudson Falls,NY 12839
Death Certificate Filed District Number Register Number
City, Town or Village Hadley
❑Burial Date 04/13/2015 Cemetery or CrematoryPineview Crematory
❑Entombment Address
®Cremation Quaker Road, Queensbury,NY 12804
Date Place Removed
❑ Removal and/or Held
00 and/or Address
Hold
Date Point of
y 0 Transportation Shipment
• by Common Destination
Carrier
❑ Disinterment Date Cemetery Address
El
Renterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Densmore Funeral Home 00448
Address
7 Sherman Ave, Corinth,NY 12822
Name of Funeral Firm Making Disposition or to Whom
:,: Remains are Shipped, If Other than Above
': Address
Permission is hereby granted to dispose of the human re ns described above as indica� d.
Date Issued 7�/g,/ S-' Registrar of Vital Statistics , c./lrn e 0 ,6-Y1-tre-X1(;1
(signature)
District Number L/ $rj Place -ut32
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
i Date of Disposition giiIiic Place of Disposition "fink Cam'
(address)
R
t"` (section) (lot number)(� (grave number)
4.
Name of Sexton or Person in Charge of Premises G1'=� Jzn
► ( ease print)
10 Signature 4- Title fltEw` ac
(over)
DOH-1555 (02/2004)