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Krieger, Lillian NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit. Vital Records Section 77 Name First Mid IegWy Last Sex LILLIAN A. KRIEGER FEMALE r Date of Death Age If Veteran of U.S.Armed Forces, 104 7/2013 72 War or Dates NO -- Place of Death Hospital, Institution City,Town or Village City of Albany or Street Address ALBANY MEDICAL CENTER HOSPITAL ' Manner of Death ® Natural ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined ❑ Pending Cause Circumstances Investigation Medical Certifier Name Title ANNIE LACAVALIER MD Address 43 NEW SCOTLAND AVE. ALBANY, NY 12208 3 „? Death Certificate Filed District Number Register Number City,Town or Village City of Albany 101 1896 Date Cemetery or Crematory ❑ Burial 10/14/2013 PINEVIEW CREMATORY ❑ Entombment Address ® Cremation QUEENSBURY, NY Date Place Removed Z Removal and/or Held 2 ❑ and/or Address , Hold Cl) Date Point of CD Transportation Shipment CO 0 By Common Destination a Carrier ❑ Disinterment Date Cemetery Address ❑ Date Cemetery Address Reinterment _'? Permit Issued To Registration Number -. Name of Funeral Home REGAN DENNY STAFFORD FUNERAL HOME 01443 Address "' 53 QUACKER ROAD QUEENSBURY, NY 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address ILI 0 Permission is hereby granted to dispose of the human remains described above as indicate Date 10/09/2013 J Registrar of Vital Statists �;, Issued (signature) District Number 101 Place City of Albany, NY I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 2. Date of Disposition It)/i l.Ii3 Place of Disposition R on tui G r1i,-.. ut (address) 2 Lul © (section) (lot num r) c Omit (grave number) Z 4 Name of Sexton or Person in Charge of Premise eistl -X ! (please print) �1n II ILI Signature Title C W� 1 (over) DOH-1555(02/2004)