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Alden, Eileen E NEW YORK STATE DEPARTMENT OF HEALTH 1 Burial - Transit Perm Bureau of Biostatistics -Vital Records Section it Name First Middle Last Sex Eileen Elizabeth Alden Female ::::.Date:::::: ... ..................................................................................... .........::...................................................:::::::::::...:::..................::::::::::::::::::::::::::::::::::.:::::::::.::::...::::::::::...:.............................................:'....... of Death Age If Veteran of U.S.Armed Forces, March 12, 1988 39 War or Dates . ........................ Z; ace of Death Hospital, Institution or City,Town or Village Hudson Fails Street Address Hudson River .............. ....... ....: ....... _...... . ::: ....... ::::::::::::::::::::::::::::::::::::::::::::::::.............:::::::::......:::::::.::::::::::::::::::::::::::..:::::::::::::::::::::::::::.. Cause of Death Probable Drowning ( Pending Toxifogical Exam of Internal Organs ) C�:::::.....................::......:::::::::::::.::::::::::::::::::::::::::::._::::::::::::::::::::::,:,:: .:::::::::::::::::::::::::::::::: ......::::......................................................... Medical Certifier Name Title p' Richard T. Hogan Coroner's Physician .....................................:::::::Address:::::................................................................................................................................................................................................ .............. Main ST. , Hudson Fails, N.Y. .:: .:::::. .................................................... ...................................... .. Death Certificate Filed ': District Number Register Number City,Town or Village Hudson Falls 5726 5 Date :; Cemetery or Crematory El Burial March 14, 1988 Pine View Crematory :.......:.....................,............:::::::.........::::::::.........::::.:..:...;:.......:................::.:::.........:..:.:..:................:..:::.::...:....... ...........:.::::::.::::.::.........:....... ®Cremation : Address Town of Queensbury, N.Y. ...............:>::.Date:::::.................................................................. .......................................................................................... ...... Z Place Removed O< ❑ Removal and/or Held and/or .........>: ........................................................................................................................................................... !—> d Address Jir ...........................................................................................................::..... Date ..:. .... tl Point of W ❑Transportation by Shipment C ...... a> Common Carrier :;::.......: . .................... ......................::. ..............................................................:...:::::::::::::::::::::,:::::::::::::::::::::::::::::::::::.:::::::::::::: ::: Destination ate::::......................................................... ............. D ............................................... El Disinterment Cemetery Address ..........................................>..............:.....:::.::.:::.:::.........:::::::..:::::::. ; ....:.......::...:..:........::.:::.:::::::....... ................. Date Cemetery Address ❑ Reinterment Permit Issued to Registration Number Name of Funeral Firm Sullivan, Minihan & Potter, Inc. 02397 Address:..................................................................................................................................................................................................................................................... Park Street , Glens FAlls, N.Y. 12801 Name.of.Furieral Firm:::::. ... ............................................................................................................................................ ` Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is hereby granted to dispose of the human remains describe above —ass-Indicated. Date Issued 3/24/88 Registrar of Vital Statistics� � rn� (signature) District Number 5726 Place Village of Hudson Fails, N.Y. I certify that the remains of the decedent identified above were disposed of in accordance with this ,ppermitt on: Z. Date of Disposition 3 f `Ov Place of Disposition (address) Cn (section) (lot number) (grave number) 0 p Name of Sexton or Person in harge of Premises 7 Z `�' ase �) X to Signature \Y Title /�/� c�/ DOH - 1555 (9/86)p 1 of 2(formerly VS-61)