Loading...
Lama, Catherine NEW YORK STATE DEPARTMENT OF HEALTH ` g`‘ Vital Records Section Burial - Transit Permit Name First Middle Last Sex Catherine M. Lama Female Date of Death Age If Veteran of U.S. Armed Forces, 11/01/2018 91 Years War or Dates Place of Death Hospital, Institution or - City, Town or Village Granville Village Street Address Indian River Rehabilitation And Nursing Center Manner of Death Undetermined Pending ©Natural Cause Accident Homicide Suicide t Circumstances Investigation t Medical Certifier Name Title Leonard Gelman MD Address 17 Madison St,Granville Village, New York 12832 Death Certificate Filed District Number Register Number = City, Town or Village Granville Village 5725 46 Burial Date Cemetery or Crematory 11/05/2018 Pine View Crematory • El Entombment Address ®Cremation Queensbury Town, New York Date Place Removed ❑Removal and/or Held u. and/or Address Hold Date Point of ❑Transportation Shipment by Common Destination Carrier Disinterment Date Cemetery Address ID Date Cemetery Address 0 Reinterment Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 Address 24 Church Street PO Box 500, Lake Luzerne, New York 12846 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 11/02/2018 Registrar of Vital Statistics r*,icharc-rp6erts(ECectronica!(ySigned) (signature) District Number 5725 Place Granville Village, New York certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition II/5 its Place of Disposition '.10 1 1,,,Aortj (address) (section) (lob number) (grave number) - Name of Sexton or Person in Charge of Premises (hri L Sy-�n'� Signature (ple print) telt e A 4- Title CA Pf (over) DOH-1555 (02/2004)