Kennedy, Margaret NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
7,7 Name First Middle Last Sex
_ Margaret A.Kennedy Female
Date of Death Age If Veteran of U.S.Armed Forces,
12/28/2018 83 Years War or Dates
Place of Death Hospital, Institution or
€ City, Town or Village Albany Street Address Albany Medical Center Hospital
Manner of Death Ix Natural Cause Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
Daniel Pauze MD
Address
F. 43 New Scotland Ave,Albany,New York 12208
.� Death Certificate Filed District Number Register Number
. City, Town or Village Albany 0101 2891
'Burial Date Cemetery or Crematory
12/31/2018 Pine View Crematory
❑Entombment
Address
®Cremation Queensbury Town, New York
Date Place Removed
Removal and/or Heldand/or
Address
_: Hold
' Date Point of
i Transportation Shipment
;11 by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079
Address
82 Broadway,Fort Edward,New York 12828
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
ax Address
3.. Permission is hereby granted to dispose of the human remains described above as indicated.
IA Date Issued 12/31/2018 Registrar of Vital Statistics Danielle S Gillespie(ElectronicaClySigned)
(signature)
District Number 0101 Place Albany, New York
_: I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition .f /ONO Place of Disposition 7 it,,, l4atwe
(address)
, I iiiii (section) (lot number) (grave number)
• Name of Sexton or Person in Ch rge of Pre ,'ses t Ar»1 t- �GhA4tt
µ /� (p e ant) J
Ia' L
Signature Title
(over)
DOH-1555 (02/2004)