Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
LaMay, Robert
11SbL NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit ::.. Name First Middle Last Sex N. Robert P. LaMay Male j:•E Date of Death Age If Veteran of U.S. Armed Forces, July 31, 2015 75 War or Dates 1958-1959 1 Place of Death Hospital, Institution or City, Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death I X)Natural Cause Accident I I Homicide Suicide Undetermined Pending Circumstances Investigation . Medical Certifier Name Title E Marvin Davidowitz MD 'r' Address r. 100 Park Avenue Glens Falls,NY ' Death Certificate Filed District Number t Regist r Number :::r City, Town or Village �c0 1 0s-1 ❑Burial Date Cemetery or Crematory August 4, 2015 Pine View Crematorium ❑Entombment Address 0 Cremation Quaker Road, Queensbury, NY 12804 Date Place Removed ZZ I I Removal and/or Held and/or Address H Hold p Q Date Point of NI I Transportation Shipment p by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address I I;:; Permit Issued to Registration Number ER Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 ;ti : Address :j: 407 Bay Road,Queensbury, NY 12804 E: :: Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address ' Permission is hereby ranted to dispose of the human remains de ribe a ve icated. r:r ©3 !� �� Date Issued �� Registrar of Vital Statistics (signature) District Number S Z.70/ Place6'14.. /7q/`S /1)/ }; I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition ' /SirPlace of Disposition Filed-J C'c.'c-- 2 (address) W co 0 (section) kflot number) (grave number) pp Name of Sexton or Person in Charge of Premises t 4 r,1 Z (pleTse print) W Signature C.- Title faZ'Ffh1111C (over) DOH-1555(02/2004)