Plummer, Gail NEW YORK STATE DEPARTMENT OF HEALTH r ��
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Gail S. Plummer Female
Date of Death Age If Veteran of U.S. Armed Forces,
04/01/2015 70 years War or Dates
Place of Death Hospital, Institution or
Z. City, To,cx x' xXX Saratoga Springs Street Address SaratoAHospital
i Manner of Death Q,Natural Cause 0 Accident Homicide 0 Suicide Undetermined 0 Pending
last Circumstances Investigation
ILI Medical Certifier Name Title
b Frederick Reynolds M D
Address
381 Church St Saratoga Springs N Y
Death Certificate Filed District Number Register Number
City, ToX1OOXVAXOSKX Saratoga Springs 4501 16P
< OBurial Date Cemetery or Crematory
[]Entombment 04/06/2014 Pineview Crematory •
Address
(Cremation Queensbury, N Y
Date Place Removed
Z Removal and/or Held
C2❑and/or Address
H Hold
C? Date Point of
Q'El Transportation Shipment
G! by Common Destination
Carrier
0 Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Densmore Funeral Home 0p448
Address
7 Sherman Ave, Corinth, New York 12822
Name of Funeral Firm Making Disposition or to Whom
# Remains are Shipped, If Other than Above
2 Address
2
ILI
Permission is hereby granted to dispose of the human remains ib ab dicated
Date Issued 04/02/2015 Registrar of Vital Statistics as
(signature)
District Number 4501 Place Saratoga Springs
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
�„ <n
ILI Date of Disposition too Place of Disposition FINAL/ 6ir:
(address)
tin
cc (section) L -t�''(lot numbe (grave number)
flName of Sexton or Person in Charge of Premises t'
(please print)
Signature '`' Title 471f4+rti4
(over)
DOH-1555 (02/2004)