Hilfinger, Marion sl2--
NEW YORK STATE DEPARTMENT OF HEALTH ' Burial - Transit Permit
Vital Records Section
Name First Middle Last ' Sex
Marion E. Hilfinger Female
Date of Death ' Age If Veteran of U.S. Armed Forces,
August 26,2013 88 War or Dates
E. Place of Death Hospital, Institution or
Z City,Town or Village Washington Street Address The Orchard Nursing Centre,Inc.
pManner of Death a Natural Cause Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
W Medical Certifier Name Title
0
Address
Death Certificate Filed District Number Register Number
City, Town or Village Granville b 7S1,9 3g
❑Burial Date Cemetery or Crematory
August 29,2013 Pine View Crematorium
Address
®Cremation 21 Quaker Road,Queensbury,NY 12804
Date Place Removed
z Removal and/or Held
and/or Address
F. Hold
N
O Date Point of
N D Transportation Shipment
p by Common Destination
Carrier
0 Disinterment Date Cemetery Address
ID 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
t— Remains are Shipped, If Other than Above
2 Address
re
W
a. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 000610i.3 Registrar of Vital Statistics _ Yv it)12adZQQe,
?--vt-v1-1-4.
( ' nature)
District Number 5'7 , Place Granville
I certify that the remains of the decedent identified above w disposed of in a rdance with this permit on:
Z //'
Lu Date of Disposition c Place of Disposition i0r/rl�, �t d Z%
W (address)
U)
rg
(section) ���eY/" : � , )�� (grave number)
Z Name of Sexton •�:rs nn r of Premises G`�(„en
�Iri, QZ2Z°Signature .I � d Title
(over)
DOH-1555(02/2004)