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Harrington, Ruth r `/(y NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Ruth G. Harrington female <' Date of Death Age If Veteran of U.S. Armed Forces, 2/15/1997 69 War or Dates no Place of Death Hospital, Institution or City, Town or Village City of Glens Fall SStreet Address Glens Falls Hospital ::. 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, New York 12801 --[-Death Certificate Filed District Number Register Number City, Town or Village City of Glens Falls Date Cemetery or Crematory ❑Burial Feb. 18, 1997 Pine View Crematory Address Queensbur New York ®Cremation Y $ Date Place Removed FI Removal and/or Held ••• and/or Address Hold Date Point of W❑Transportation Shipment by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address <? Permit Issued to Registration Number .. Name of Funeral Home Regan and Denny Funeral Service, Inc. 01583 Address 53 Quaker Road, Queensbury, new York 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address [ Permission is hereby ranted to dispose of the human remains described above a di ated. Date Issued o? /F� Q 7 Registrar of Vital Statistics ./� (signature) / District Number Place I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: f- _ Date of Disposition �� -� "'f�� Place of Disposition i /�� /� [o'%� C ('e,�Y)d,)cC,f� ` (address) UJI M (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises 14 ��� ,LY r e (please print) Signature k? �'� Title C' �� � '> ate`iso�fti"1r DOH-1555 (10/89) p. 1 of 2 VS-61