Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Cherney, Amanda Jean
gl►g1 NEW YORK STATE DEPARTMENT OF HEALTH • Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Amanda Jean Cherney Female Date of Death Age If Veteran of U.S.Armed Forces, 11/03/2020 43 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W ©Manner of DeathUndetermined n Pending � Natural Cause 1=1Accident 1=1Homicide Suicide W Circumstances Investigation W• Medical Certifier Name Title Scott Biasetti MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 495 Burial Date Cemetery,Crematory or Facility Name 11/05/2020 Pine View Crematorium ElEntombment Address Cremation Queensbury Town,New York ElDonation o Removal Date Place Removed and/or and/or Held H Hold Address 0 a Date Point of t/) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom I— Remains are Shipped,If Other than Above Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/04/2020 Registrar of Vital Statistics cRp6ertAndrew Curtis(ECectronically Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit - 1 Z Date of Disposition /t!5�ZO Place of Disposition 2 (address) W CC CC (section) (iotnum er/ (grave number) O Name of Sexton or Person in arge of Premises ` r'�1 Z (pteaseibrint) W Signature S Title 6 �� DOH-1555(07/18)p i of 2 Public Health Law Sec. 4145(2b) 1 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#