Harrington, Anthony NEW YORK STATE DEPARTMENT OF HEALTH -.4:t—ZZ )
Vital Records Section s Burial - Transit Permit
Name First Middle Last Sex
ANTHONY ROGF,R HHRRING'LDN male
Date of Death Age If Veteran of U.S. Armed Forces,
F May 29, 2013 52 War or Dates _0_
WPlace of Death Hospital, Institution or
City,xlmoogroimatoc Glens Falls Street Address Glens Falls Hospital
0 Manner of Death 0 Natural Cause Ill Accident 0 Homicide OSuicide 0 Undetermined ❑ Pending
W Circumstances Investigation
U Medical Certifier Name Title
W Joseph Mihindu, MD
d Address
Glens Falls, NY
46, Death Certificate Filed District Number Register Number
R City, Glens Falls `5' /
Date Cemetery or Crematory
[' Burial May 31 , 2013 Pine View Crematorium
Address
Cremation
2 Tn of Queensbury, NY
Date Place Removed
0 0 Removal and/or Held
- and/or Address •
Hold
Date Point of
0El Transportation Shipment
d by Common Destination
0 Carrier
Date Cemetery Address
a Disinterment
❑ Reinterment Date Cemetery Address
Permit Issued to - Registration Number
Name of Funeral Home ( rleton Funeral Home, Inc. 00281
Address
68 Main St., Hudson Falls, NY 12801
— Name of Funeral Firm Making Disposition or to Whom
ix Remains are Shipped, If Other than Above
dAddress
Permission is herebygranted to dispose of the human remains descr� ed a pas i joe,/ -d.
Date Issued j�.S 3r/20#3 Registrar of Vital Statistics
(signature)
District Number 5601 Place City of Clcns Fallc, NY
I- I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 013i 0 Place of DispositionC ii—
2 (address)
IV
dt (section) (I numb ) (grave number)
Name of Sexton or Person in Charge of Premises ,,,,+, Jer,u4
2
W ,J'7 - (please print)
Signature if Title (" yA
T