Blood, Richard (2) M -
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STATE OF VERMONT-AGENCY OF HUMAN SERVICES- DEPARTMENT OF HEALTH
OFFICE OF THE CHIEF MEDICAL EXAMINER
MEDICAL EXAMINER'S PERMIT TO CREMATE A DEAD HUMAN BODY
DM° ,,-
PERMIT NO. 2015c -0505
Full name of decedent: Richard John Blood
Decedent's address:
Montcalm Manor
45 Montcalm St.
Ticonderoga,NY
Date of death: February 08,2015 Town of death: Burlington
Cause of death certified by: Dennis D. Woods
Permission to cremate the body of this decedent at:
Pine View Crematory
Queensbury,NY
Has been requested by: James A. Meunier
Vermont Funeral Director License Number: 022-0000010
Being sufficiently informed as to the causes and circumstances of the death of the above described
decedent, permission is hereby granted to cremate the body as requested per 18 VSA Sect. 5201 (b).
Date: February 10, 2015
Signed: (Via the Vermont Electronic Death Registration System)
Steven L. Shapiro, MD
Chief Medical Examiner
Office of the Chief Medical Examiner
111 Colchester Ave., Baird 1
Burlington, VT 05401
VDH-OCME-CP-01/2011