Trempe, Margaret NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Margaret Trempe emale
<' Date of Death Age If Veteran of U.S. Armed Forces,
April 9, 1996 80 War or Dates no
Place of Death Hospital, Institution or
City, Town or Village City of Glens Falls Street Address Glens Falls Hospital
Manner of Death®Natural Cause ❑Accident Homicide ❑Suicide ❑Undetermined ❑Pending
Circumstances Investigation
Medical Certifier Name Title
Paul Bachmann MD
Address
Warrensburg, New York 12885
Death Certificate Filed District Number Regis Number
City, Town or Village City of Glens Falls
Date Cemetery or Crematory
❑Burial April 11, 1996 Pine View Crematory
Address
[xZ Cremation Queensbury,, New York
Date Place Removed
0 ❑Removal and/or Held
•- and/or Address
>
Hold
Q Date Point of
N❑Transportation Shipment
by Common Destination
Carrier
❑Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
I
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 granted to dispose of the human remains described above as ind' ted.
Date Issued Registrar of Vital Statistics
(signature)
District Numb,"() _ Place
I certify that the remains of the decedent identified above were disposed of in ccordance with this permit on:
W Date of Disposition Z-'� Place of Disposition 0[1a
(address)
LIJ
N
cc (secti ) flot number) (grave number)
GName of Sexton or Person in Charge of Premises --�14 1? &R)4'tjE
g (please print)
Signature Title C-R-C41 P ►CJl2 "q-5,' 1
DOH-1555 (10/89) p. 1 of 2 VS-61