Dunton, Margaret NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Biostatistics-Vital Records Section
Name First Middle Last Sex
.::::.:::::.::::::::::::Margaret:::::::::::::::::.:::::::::Helen:...........--.................:..........................Dunton....................... female
Date of Death Age......................: If Veteran of U.S.Armed Forces,
6/18/1989 '70 War or Dates
.:..:::::.....................:::::::.:::::::::::::::::::::.:::::::::::::::::::::::::::::::::::::.:::::::::::::::::: : . .:..........................n... ..........................
Place of Death Hospital, Institution or
City,Town or Village Street Address
Y. 9 City of Glens Falls Glens_.Falls..Hos .ital
C C aus e of Death
::::: cardio.. ulmona renal failure due: :. '..... . : :.::.:...............:...:..: ......................................
Medical Certifier Name Title...... ....... .....
.6 Harold J. Luria MD
Adiiress:::::.................................................................................................................................................
.........................
...................................
25 May Street, Glens Falls, New York 12801
;.:.:beath Certificate'Filed'*"**............................................................... .......................
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District Number R ister Number
City,Town or Village City of Glens Falls
Date Cemetery or Crematory
❑Burial
6/20/89 Pine View Crematorium
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Cremation Address
Town of Queensbury, New York
.:..:::.:...........:.:.:::::.......................:... ..... . ...:..:.::...........:...:.:::::::::::::::..::............:::::.::.:::::::::::::::::.:.::.:..........:.::::.:.:..::. .
Z! Date : Place Removed
0 ❑ Removal : and/or Held
and/or Hold ..........::....:::::::::::::::::::::::::.::::::::::::::::::::::::::: ::.................::::::::::......::::::::............::::::::.::...........::::::.....:::::............:::..............
Address
Q!.:::.................... : .::::::.. ...................
a' Date Point of...................................... ......................................................................
cn; ❑Transportation by Shipment
Common Carrier
O .......................:.. ..... .... ............
Destination
...................................................::... . ..
El Disinterment
Date CemeteryAddress
.............:..
...................
El Reinterment Date Cemetery Address
Permit Issued to : Registration Number
Name of Funeral Firm Re an and Dennyuneral._Service, Inc................... 0.......:.:::.........:..:::::..:........................... ::::...........................::.Y:::.::::..:::..:...... 28 3..................................::::
..... ... ..
Address 26 Quaker Road, Queensbu ry, New York 12804
Name of Funeral Fir.::::: .... ..............................................................................................................................................................
.. m Making Disposition or to Whom
Remains are Shipped, If Other than Above
ui
Address
::::.................................................................................................................... ..............................................................................................................
Permission is hereby granted to dispose of the hums maiinsdescriibb / above s indicated.
Date Issued Registrar of Vital Statistics
(signature)
District Number O/ Place ,U/ �j
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
w' Date of Disposition pLe-v Place of Disposition //5�.��/,�� �if�.��Yf/9 �/17
(address)
w
(section) (lot number) (grave number)
" g ,F",ai9�i 17 �r9TiP/94�pI Name of Sexton or erson i Char a of Pr mises
z (Lase print) 1,45Y1
p ,
ul Signature Title /�i�/1'1/9�/�y 5Y1 T
DOH-1555(9/86)p 1 of 2(formerly VS-61)