Loading...
Mulvany, Mary NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Mary Mulvany Female Date of Death Age If Veteran of U.S. Armed Forces, August 20, 2013 77 War or Dates t,, : Place of Death Hospital, Institution or X City, Town or Village Glens Falls Street Address The Pines Of Glens Falls W Manner of Death Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined El Pending ttit Circumstances Investigation Medical Certifier Name Title a l'- c-,&3S---s,( -k4 1\ckX r( .0 AG ress C,-i- ass I i \ i10 ( - f Death Certificate Filed District Number Register Number ,;i City, Town or Village Glens Falls,NY 5601 - ❑Burial Date Cemetery or Crematory August 22,2013 Pine View Crematorium ❑Entombment Address ©Cremation Quaker Road, Queensbury,NY 12804 Date Place Removed Z ❑Removal and/or Held 2 and/or Address H Hold U) 0 Date Point of Ds ❑Transportation • Shipment p by Common Destination Carrier ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address 1 Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 /I Address s 53 Quaker Road, Queensbury,NY 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued g f7/3 Registrar of Vital Statistics Ckdt...r-Q-w (signatu ) District Number 5601 Place Glens Falls,NY I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition 6Iu(l3 Place of Disposition F,e tu.r 6*Peto-r it, 2 (address) W C (section) �lot number) (grave number) pName of Sexton or Perso in Charg f Premises ill SpF -- Z (plea a print) W Signature Title CaCtittnt L (over) DOH-1555(02/2004)