Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Conlon, Dori
NEW YORK STATE DEPARTMENT OF HEALTH 73 Vital Records Section Burial - Transit Permit Name First Middle Last Sex .:„. Dori L. Conlon Female try' Date of Death Age If Veteran of U.S. Armed Forces, : March 23, 2015 52 War or Dates 4: Place of Depth Hospital, Institution or City, Town ^r Village Glens Falls Street Address Glens Falls Hospital Manner r` -pith IN. Natural Cause Accident n Homicide Suicide Undetermined n Pending Circumstances Investigation et, Medical Cr rifier Name Title Daniel Way Address HI71►!v, „t h Creek, NY 12853 District Number ! �/ Register Number_ Cit '' la'- Glens Falls rL57- / /�-5r ❑Burial Date Cemetery or Crematory / March 30, 2015 Pine View Crematory ❑Entombs ' Address ©Creme! Jn 121 Quaker Rd., Queensbury, NY 12804 Date- Place Removed and/or Held O_ H d -s en 0 ' Cate Point of a. c T roes: ;r tion Shipment " =a nestination :ate Cemetery Address j r �tc - ,t ate Cemetery Address Per •-) Registration Number Na al H e Alexander-Baker Funeral Home 00037 - A- 3 rrer. 'y'arrensburg, NY 12885 C: . Making Disposition or to Whom f--: Rer •-rip: If Other than Above Ad, a Pe, her ,' granted to dispose of the human remains described above as indicated. r, 3 (2_6/f c Registrar of Vital Statistics `/\--)C 4 (signatul ) Dis 'r 5.6 0./ Place Glens Falls/ RAJ r 1 I cr ` t re as of the decedent identified above were disposed of in accordance with this permit on: w D r D" 3J)//t3 Place of Disposition !��y /C, a..i Cn-0-- Li (address) (section) (lot number) (grave number) Na ` c rson in Charge of Premises , 4 ' °(please print) : Sir u'_ G'� Title (.1z Pik_ (over) 1 DC-1 :)