Mulvey, Linda NEW YORK STATE DEPARTMENT OF HEALTH 5/1
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Linda E. Mulvey Female
Date of Death Age If Veteran of U.S. Armed Forces,
May 27,2015 64 War or Dates
Place of Death Hospital, Institution or
Z City, Town or Village Glens Falls Street Address Glens Falls Hospital
pManner of Death X Natural Cause Accident n Homicide Suicide Undetermined Pending
Circumstances Investigation
ww,#; Medical Certifier Name Title
Susan Blood
Address
453 Dixon Rd.,Queensbury,NY 12804
Death Certificate Filed District Number Register Number
City, Town or Village 560/ 266
❑Burial Date Cemetery or Crematory
May 29,2015 Pine View Crematory
Entombment Address
El Cremation 21 Quaker Rd., Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
52 and/or Address
�' Hold
N
O Date Point of
N Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander-Baker Funeral Home 00037
Address
3809 Main Street,Warrensburg,NY 12885
Name of Funeral Firm Making Disposition or to Whom
!_- Remains are Shipped, If Other than Above
X. Address
W
• Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 5 /2-s, /5 Registrar of Vital Statistics eA, ti-
(signatur
District Number To] Place s ) )5, t J
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
`
W• Date of Disposition o J25Ijc Place of Disposition Mi�.J C�'+- or;✓
W (address)
N
(section) (lot number) S (grave number)
pName of Sexton or Pt; son in Charge of Premises �,.. �. .otAt
Z / (lease print)
W Signature Title tizE4•4 DAL
(over)
DOH-1555 (02/2004)