Hunt, Francis L NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Biostatistics -Vital Records Section
Name First Middle Last Sex
Francis. . ...... . L..._......._.........._........._..............._H_unt Male
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Date of Death Age If Veteran of U.S.Armed Forces,
........_ .�.n.e....24.x.....�.9.8.8.............._.. 80.. WarorDates Yes W.W. II.......................::.....::..::............:......:...................:..::::::._:.:.:::::::::...:.:::........;_:.::.:..............:...:::.......::::::............. ....::::::......::::::...................................................
Place of Death Hospital, Institution or
City,Town or Village Altamont Street Address Mercy Healthcare Center.::,.........:...::::::::::::::::::::::::.::::.::...:::::.:::::._:::::::::,:::::::::.:.:::.:::::::,::::::......................::::::.::::::::::y:..::::::::::::::::.
D: Cause of Death ...........................:::::::::::::::::::::::: .......
...:.
' Cardiac Arrest.
:3 :.....................:: ......:::: .....::: ...... ......:::::.........................................................
LJ Medical Certifier Name Title
C3 Dr. LaVallee
`......0............................................
Address
::.t
Lake Placid, NY
eah Certificate File d District Number Register Number
XXX
:::
City,Town or Village Altamont 1650
Cemetery Date
r. ry o Crematory
El Burial June 25 1988 Pine View Cremator
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®Cremation Address
Queensbury . NY
Z. Date Place Removed
01 Removal and/or Held
and/or Hold ._.....::::. ............:: .............._............ ........ ................._:::........:::::::.................::::.....:............:::::::::.......... :::.... ......:::::.......... :::
Address
rZ: Date Point of .........................................................................:..:::.:::.
Ni ❑Transportation by Shipment
n: Common Carrier
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.
Destination
.:Date::::::..................................................... ... .......................................................................................................
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❑ Disinterment : Cemetery Address
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Date Cemetery Address
❑ Reinterment ddr
Permit Issued to Registration Number
Name of Funeral Firm Brewer Funeral Home Inc. 00243
Address
<' P .O . Box 500 Lake Luzerne NY 12846
..................................................................................
f Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
..........................................
Permission Is hereby granted to dispose of the dead human remains described above as indicated.
Date Issued 6/24/$8 Registrar of Vital Statistics .z..-zzz �Jcl
(signature)
District Number 1650 Place Tupper Lake , NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z.W: Date of Disposition l Place of Disposition j� 1�1 � e114W / e
(address) '
'w
(section)/ /J p (lot number) (grave number)
pName of Secton o ersoXinrge of Premise
lu
Z please print) �` S r
Signature Titleen
DOH-1555(9/86)p 1 of 2(formerly VS-61)