Gatto, Frank tt 727 ,
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section c Burial - Transit Permit
Name First Middle Last Sex
Frank A Gatto Male
Date of Death Age If Veteran of U.S. Armed Forces,
04/1 8/2013 80 years War or Dates Yes
14 Place of Death Hospital, Institution or
City, Tow i Street Address
114 CX Glens Fails Glens Falls Hospital
Manner of Death r��t Natural Cause 0 Accident Homicide Suicide Undetermined Pending
l�ti Circumstances Investigation
1fa Medical Certifier Name Title
0 Marvin rlavidowitz M D
Address
100 Park St Glens Falls, N Y 12801
Death Certificate Filed District Number Register Number
City, TowttnyiI XX Glens Falls 5601 163
Pi Burial Date Cemetery or Crematory
gli
❑Entombment 04/19/2013 Pine View Crematorium
Address
emation Queensbury. NY 12804
Date Place Removed
Z Removal and/or Held
❑and/or
Address i;;;
Hold
Date Point of
it')Ei Transportation Shipment
L: by Common Destination
Carrier
Q Disinterment Date Cemetery Address:iiii
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M. B. Kilmer Funeral Home 01079
Address
82 Broadway, Fort Edward, NY 12828
Name of Funeral Firm Making Disposition or to Whom
}r Remains are Shipped, If Other than Above
Address
CC
tJ
CL
Permission is hereby granted to dispose of the human remains described above as indicated.
giNi Date Issued 04/19/2013 Registrar of Vital Statistics ( CA.."1/441..%9 k.A)4~(sign re)
District Number iiiiig 5601 Place Glens Fallsdki y
1. I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
2
ILI Date of Disposition '-f-Z213 Place of Disposition -8,sUK W rtemsior,4r•-
(address)
ia
Cl
CC (section) A (lot number) (grave number)
ci Name of Sexton or Per on in Charge of, remises �J
(p ase print)
Signature IL-
m-- Title C Ivy W1 ,
(over)
DOH-1555 (02/2004)