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Ferranti, Anthony NEW YORK STATE DEPARTMENT OF HEALTH 1 h. , � Vital Records Section Burial - Transit Permit Name First Middle Last Sex M Anthony S. Ferranti Male .::'s Date of Death Age If Veteran of U.S. Armed Forces, December 7, 2015 87 War or Dates NA •s Place of Death 0 Hospital, Institution or City, Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death X Natural Cause I Accident Homicide Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title r ' Mathew Varughese MD .▪ ... Address 100 Park Street,Glens Falls,NY :: ; Death Certificate Filed District Number 11 Register Number ; City, Town or Village Glens Falls, NY ©d ' s 5 a) ❑Burial Date Cemetery or Crematory December 9, 2015 Pine View Crematorium ❑Entombment Address E1 Cremation Quaker Road, Queensbury, NY 12804 Date Place Removed z0'I I Removal and/or Held and/or Address H Hold N O Date Point of NTransportation Shipment Q by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address ::� Permit Issued to Registration Number • Name of Funeral Home Regan Denny Stafford Funeral Home 01443 • ^'' Address A': 53 Quaker Road, Queensbury,NY 12804 :h' Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Id N.:: Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued /c2 %%�l77r Registrar of Vital Statistics wC�Lk L- / (signature) District Number 560/ Place 6/ r'j--l`.4j //$ I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition jatn lIS Place of Disposition Zi V.,,1 W (address) co O (section) / Y (lot nur) (grave number) ra O Name of Sexton or Person in Char a of Premises t�ht,r} cIlr t%ni0� Z ` please print) W Signature Title l 0-0k. (over) DOH-1555(02/2004)