Craig, Margaret NEW YORK STATE DEP.JTMENT OF HEALTH #Sg0
Vital Records Section Burial - Transit Permit
- Name First Middle Last Sex
Margaret N. Craig Female
Date of Death Age +f Veteran of U.S. Armed Forces,
December 10, 2015 88 War or Dates
IFS' Place of Death Hospital, Institution or
Z City, Town or Village Glens Falls Street Address Glens Falls Hospital
rir Manner of Death X❑Natural Cause ❑ Accident 0 Homicide ❑ Suicide ❑ Undetermined ❑ Pending
( Circumstances Investigation
Ilt Medical Certifier Name Title
a
Address
Death Certificate Filed District Number Register Number
" City, Town or Village 5 6 0 ) 5 6
' �❑Burial Date Cemetery or Crematory
December 11, 2015 Pine View Crematorium
_,,V❑Entombment Address
. ®Cremation Quaker Road Queensbury,NY 12804
Date Place Removed
,�z;❑ Removal and/or Held
and/or Address
Hold
071
0 Date Point of
tL ❑Transportation Shipment
0) by Common Destination
Q Carrier
❑ Disinterment Date Cemetery Address
' ❑ Reinterment Date Cemetery Address
" Permit Issued to Registration Number
Name of Funeral Home Carleton Funeral Home, Inc. 00281
'' Address
Carleton Funeral Home, Inc. 68 Main St., P. O. Box 67 Hudson Falls, NY 12839
Name of Funeral Firm Making Disposition or to Whom
I' Remains are Shipped, If Other than Above
' Address
W`
Permission is hereby granted to dispose of the human remains described above as indicated.
', Date Issued i 2 / c , //5' Registrar of Vital Statistics CA ti
(signature)
District Number 5 to l Place 6(szA/`S \\s } y%
▪ I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W; Date of Disposition 12/11/2015 Place of Disposition Quaker Road Queensbury,NY 12804
;'' (address)
w
Ct (section) q (lot numbs (grave number)
0` Name of Sexton or Person in Charge f Premises ^r.. iiAiliet(please print)
W Signature Title ( t
(over)
DOH-1555 (02/2004)