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LaPoint, Albert NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Albert LaPoint W. Date of Death male Age If Veteran of U.S. Armed Forces, 12/10/1999 74 War or Dates WWII Place of Death Hospital, Institution or (Kk , Townom x�C/X1tc Moreau Street Address 137 Reservoir Road Manner of Death©Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title Michael Castro, MD. Address 102 Park Street, Glens Falls, NY 12801 . Death Certificate Filed District Number Register Number It , Town oXX Mooeau Date Cemetery or Crematory ❑Burial 12/13/1999 Pine View Crematory Mv Address Cremation Quaker Road, Queensbury, NY 12804 Date Place Removed 0 ❑Removal and/or Held and/or Address Hold F� 0 Date Point of Q Transportation Shipment by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address >< Permit Issued to Registration Number Name of Funeral Home Regan & Denny Funeral Home 01595 Address 94 Saratoga Avenue, South Glens Falls, NY 12803 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 huma i describ above as indicated. ijijijij� Date Issued Registrar of Vital Statistic7o,zi signature) District Number Place �fj Jj I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: f- W Date of Disposition a-'t' Place of Disposition (d� Lu (address) W (section) n �(lot number (grave number) FName of Sexton or Person in Charge of Premises (please print) W Signature y — C Title (over) DOH-1555 (9/98)