Lindner, Margaret NEW YORK STATE DEPARTMENT OF HEALTH 0 3ki 1
Vital Records Section ,, Burial - Transit Permit
. Name First Middle Last Sex
Margaret E. Lindner Female
Date of Death Age If Veteran of U.S. Armed Forces,
June 7,2013 94 War or Dates
Place of Death Hospital, Institution or
• City, Town or Village T/of Lake George Street Address 52 Morgan Court
• Manner of Death 0 Natural Cause n Accident n Homicide ❑Suicide n Undetermined n Pending
Circumstances Investigation
Medical Certifier Name Title
Anthony Petracca MD
{ Address
3 Irongate Center
• 1 Death Certificate Filed District Number Register umber
z" ., City, Town or Village Lake George Lake George7
7,„,,
❑Burial Date Cemetery or Crematory
June 11, 2013 Pine View Crematory
❑Entombment Address
El Cremation Quaker Road, Queeensbury,NY
Date Place Removed
z ❑Removal and/or Held
O and/or Address
E Hold
Cl)
O Date Point of
NE Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
DRenterment Date Cemetery Address
r? Permit Issued to Registration Number
`'' Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Xr f'
'' f Address
53 Quaker Road, Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
w
Permission is hereby granted to dispose of the human remains described above a Indic ted.
r;; Date Issued �2�(t _�3 Registrar of Vital Statistics 0� k a •
.,
(signature)
District Number Lake George Place Lake George
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition (0)ItI13 Place of Disposition � ,..1 64eec(ct --
2 (address)
W
U) (section) 4 _ (lo number)r--- (grave number)
p Name of Sexton or Person in Charge of Premises
Z (,Tease pant)
ifiL 2..._
W Title C A+AI'�DtZ.
Signature
(over)
DOH-1555(02/2004)