Bodette, Lester NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Lester Sodette male
Date of Death Age If Veteran of U.S. Armed Forces,
July 9, 1996 87 War or Dates no
Place of Death Hospital, Institution or
City, Town or Village Town of Queensbury Street Address Hallmark Nursing Centre
Manner of Death®Natural Cause Accident Homicide Suicide 0 Undetermined El
Pending
Circumstances Investigation
Medical Certifier Name Title
Richard Spitzer MD
Address
55 Sheridan Street, Glens Falls, New York 12801
Death Certificate Filed District Number Register Number
City, Town or Village Town of Queensbury —
Date Cemetery or Crematory
❑Burial July 10, 1996 Pine View Crematory
Address
0 Cremation Queensbur New York
Date Place Removed
Z❑Removal and/or Held
... and/or Address
Hold
O Date Point of
Q Transportation Shipment
by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to RegistrA90umber
Name of Funeral Home Regan and Denny Funeral Service, Inc.
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 granted to dispose of the human rem 'ns described above indicated.
Date Issued - t�—q Registrar of Vital Statistics
signature)
District Number 5 t2 Place C�"
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
` �
W Date of Disposition �` Place of Disposition �w 1 dri�W
+� (address)
Uj
0 (sec ion) ( nurpbe (rtrave number)
Name of Sexto or Person � Charge of Pre ises ���/�
(please print) 1
» Signature Title G � i
DOH-1555 (10/89) p. 1 of 2 VS-61