Tucker, Audrey STATE OF VERMONT-AGENCY OF HUMAN SERVICES-DEPARTMENT OF HEALTH
OFFICE OF THE CHIEF MEDICAL EXAMINER
MEDICAL EXAMINER'S PERMIT TO CREMATE A DEAD HUMAN BODY
PERMIT NO. 2012c - 3116
Full name of decedent: Audrey Lee Tucker
Decedent's address:
30 Wintergreen Rd.
Queensbury,NY 11 c‘011
Date of death: November 17, 2012 Town of death: Burlington
Cause of death certified by: Deva Sharma
Permission to cremate the body of this decedent at:
Pine View Crematory
Queensbury,NY f 1U 4
Has been requested by: Steven R. Line
Vermont Funeral Director License Number: 022-0001167
Being sufficiently informed as to the causes and circumstances of the death of the above described
decedent, permission is hereby granted to cremate the body as requested per 18 VSA Sect. 5201 (b).
Date: November 18, 2012
Signed: (Via the Vermont Electronic Death Registration System)
Steven L. Shapiro, MD
Chief Medical Examiner
Office of the Chief Medical Examiner
111 Colchester Ave., Baird 1
Burlington, VT 05401
VDH-OCME-CP-01/2011