Rondeau, Joanne NEW YORK STATE DEPARTMENT OF HEALTH ttr iC 3
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joanne M. Rondeau female
Date of Death Age If Veteran of U.S. Armed Forces,
March 5, 2014 60 War or Dates _0_
Place of Death Hospital, Institution or
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City,iaacrkde Glens Falls Street Address Glens Falls Hospital
Manner of Death Natural Cause Accident Homicide Suicide Undetermined � Pending
Circumstances Investigation
llp, Medical Certifier Name Title
Francis Bellinger, MD
Address
Glens Falls, NY
Death Certificate Filed District Number Register lumber
City, TQyfr )Mil agQX Gl e s l F 1s 5601
n ' Date
❑Burial Cemetery or Crematory
March 7, 2014 Pine View Crematorium
❑Entombment Address
`'['cremation Queensbury, NY
Date Place Removedri Removal and/or Held
o and/or Address
F, Hold
0 Date Point of
iL El Transportation Shipment
0 by Common Destination
a Carrier
ElDisinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
- Name of Funeral Home Carleton Funeral Home, Inc. 00281
' Address
68 Main St. , Hudson Falls, NY 12839
Name of Funeral Firm Making Disposition or to Whom
!_=' Remains are Shipped, If Other than Above
Address
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Permission is hereby ranted to dispose of the human remains descri ovs i ed.
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� e a� Date Issued d7zoiy Registrar of Vital Statistics
(signature)
District Number
1 5601 Place City of Glens Falls, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
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iii Date of Disposition 3(litMf Place of Disposition /gist& e'ro..r4r
2 (address)
Ut
11 (section) (lot numb') (grave number)
ci Name of Sexton or Perso in Charge o Premises Adirly,L. 3t
z � (please print)
041 Signature Title Ce'o► ,
(over)
DOH-1555 (02/2004)