Wirfel, William NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle Last Sex
William M. WIRFEL
...... Male
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Date of Death Age If Veteran of U.S.Armed Forces,
July 14, 1992 69 War or Dates 1943-1945
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Place of Death Hospital, Institution or
City,Town or Village Albany Street Address DVAMC 113 Holland Avenue
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:Ao: Manner of Death 1771 Natural Cause E] Accident El Homicide El Suicide Ei Undetermined F Pending
Circumstances Investigation
Al..
.U. .. .. ........................... .......................... ............................................. ..... . ........... . ..... ...... . ...........................................
:17...
Medical Certifier Name Title
GI R. Finn MD
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Address
113 Holland Avenue Albany New York 12208
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Death Certificate Filed District Number Register Number
City,Town or Village Albany 198 200
Date Cemetery or Crematory
ElBurial
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ElCremation Address
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z Date Place Removed
2 E] Removal
and/or Held
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and/or Hold Address........ . . . .................. ........................................................................ ............................................................
Fn
0-....... ............................................... ..............................................
CL Date Point of
Ln E]Transportation by:
Shipment
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in Common Carrier
Destination'...' ,
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Disinterment F'❑ 1546.... Cemetery Address
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El Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Firm Regan & Denny Funeral Service Inc.
01602
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Address
Quaker Rd. Queensbury, New York 12804
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Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
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Address
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Permission is hereby granted to dispose of the human/jema ins.d"cribe'd above as IndipMed.
Date Issued July 14 1992 Registrar of Vital Statistics Qu rjn e'
(signature)
Place District Number
198 DVAMC 113 Holland Avenue Albany New York 12208
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition C& Place of Disposition lwlg
2 (address)
W
W
X (section) (lot number) (grave number)
0
a Name of Sexton Person in arge of Premises
f /
z print)
Signature Title �� 7,
W
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DOH-1 555 (10/89) p. 1 of 2 VS-61