Lamb, Patricia . .
NEW YORK STATE DEPARTMENT OF HEALT1i
Vital Records Section Call."4411 _urial - Transit Permit
r Name First Middle ast Sex
Patricia A Lamb ff Female
Date of Death Age If Veteran of U.S Arrl�led Forces,
08/18/2018 74 Years War or Dates
f-• Place of Death Hospital, Institution or
CityW. , Town or Village Glens Falls Street Address Glens Falls Hospital
a Manner of Death 0 Natural Cause ❑Accident ❑Homicide ❑Suicide El❑Undetermined ❑Pending
[IA Circumstances Investigation
at Medical Certifier Name Title
0 Michael Miles MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls 5601 399
❑Burial Date Cemetery or Crematory
08/23/2018 Pine View Crematory
'" ❑Entombment Address
. ®Cremation Queensbury, New York
, Date Place Removed
150 Removal and/or Held
and/or Address
Hold
Date Point of
-0!
Transportation Shipment
by Common Destination
Carrier
1 ❑Disinterment Date Cemetery Address
Q Reinterment
Date Cemetery Address
tv
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Rd,Queensbury,New York 12804
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 human remains described above as indicated.
Date Issued 08/22/2018 Registrar of Vital Statistics wp6ert A Curtis(ECectronicaCCy Signed)
(signature)
District Number 5601 Place Glens Falls, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
W Date of Disposition f-4.4-1 ii, Place of Disposition p;4t, Vtin/ C.f..,^►c 460
W (address)
GI
Le (section) (lot number) (grave number)
e3 Name of Sexton or Person in Charge of Premises T,(1
, ' tY Ste;C‹,5
z (please print)
Ui; •Signature Title fe,/k4-1-fir
(over)
DOH-1555(02/2004)