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Kane, Margaret NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Margaret Aileen Kane Female Date of Death Age If Veteran of U.S.Armed Forces, 12/27/2018 89 Years War or Dates Place of Death Hospital, Institution or City,Town or Village Schenectady Street Address Ellis Hospital - Manner of Death©Natural Cause Accident Homicide D Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title Sarah Zimmermann NP Address 1101 Nott St,Schenectady,New York 12308 Death Certificate Filed District Number Register Number City,Town or Village Schenectady 4601 1118 Burial Date Cemetery or Crematory 12/31/2018 Pine View Crematory El Entombment Address ®Cremation Queensbury, New York Date Place Removed Removal and/or Held and/or Address Hold Date Point of Q Transportation Shipment by Common Destination Carrier Li Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address h1":v 407 Bay 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 12/30/2018 Registrar of Vital Statistics CharlesWiLtizmThorne(Electronically Signed) (signature) District Number 4601 Place Schenectady, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition Via.-3i--1i Place of Disposition P Byte, yj&,W C..ftirvgcry 1 (address) (section) (lot number) (grave number) Name of Sexton or Person in Charge of Premises ttlft^t,)' S ii;_'tdc (please print) Signatur t Title `ci 6r (over) DOH-1555(02/2004)