Whiting, Margaret NEW YORK STATE DEPARTMENT OF HEALTH `, it glle
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Margaret Maureen Whiting Female
Date of Death Age If Veteran of U.S. Armed Forces,
December 29, 2014 73 War or Dates
1,, Place of Death Hospital, Institution or
City, Town or Village Queensbury, NY Street Address 7 Maine Ave
a Manner of DeathILI n ❑ ❑Undetermined n Pending
X Natural Cause Accident Homicide Suicide
Circumstances Investigation
uk Medical Certifier Name Title
0 Tim Murphy,Coroner
Address
Glens Falls,NY
Death Certificate Filed District Number Reeist r Number
City, Town or Village Queensbury,NY 5657 II
El Burial Date Cemetery or Crematory
December 31, 2014 Pine View Crematorium
❑Entombment Address
El Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z U Removal and/or Held
and/or Address
H Hold
co
0 Date Point of
N ❑Transportation Shipment
p by Common Destination
_ Carrier
[-I Disinterment Date Cemetery Address
n Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Road, Queensbury, NY 12804
Name of Funeral Firm Making Disposition or to Whom
I- Remains are Shipped, If Other than Above
Address
4. Permission is hereby granted to dispose of the human r mains described above as indicated.
Date Issued tg-1�1L)(-)ty q. a �r Registrar of Vital Statistics u---__
(signature)
District Number 5657 Place Queensbury,NY
H
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Disposition / Place of Disposition ti,� C ...cT'n....
� Date of I L i S P Ana
(address)
W
W
re (section) /',� (lot number)e, (grave number)
0 Name of Sexton or Person 'n Charg f Premises �/f�
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W C/ Title Ct iA iti
Signature
(over)
DOH-1555(02/2004)