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Towers, Loyal M.
ir 17 9 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Loyal M.Towers Male Date of Death Age If Veteran of U.S.Armed Forces, 11/28/2020 93 Years War or Dates 1944-46 Place of Death Hospital,Institution or W City,Town or Village Schenectady Street Address Ellis Hospital Manner of Death ©Natural Cause ❑Accident Homicide ❑Suicide Undetermined ❑Pending W C.) Circumstances Investigation W Medical Certifier Name Title CI Orduno Borboa MD Address 1101 Nott St,Schenectady,New York 12308 Death Certificate Filed District Number Register Number City,Town or Village Schenectady 4601 1022 EiBurial Date Cemetery,Crematory or Facility Name 11/30/2020 Pineview Crematory 0 Entombment Address ElCremation Queensbury Town,New York 0 Donation ElRemoval Date Place Removed and/or and/or Held t—N Hold Address 0 41 Date Point of U) ❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address ElReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address Q W Ct' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/29/2020 Registrar of Vital Statistics Samanta R.Mykoo(Electronically Signed) (signature) District Number 4601 Place Schenectady, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition j)130)Jo Place of Disposition "► a•, L. (address) W CC N (section) / (lotnum (grave number) 0 Name of Sexton or Person in Charge of Pre i es Z (pleise print) W Signature � Title ( µ rtk- DOH-1555(07/18)p 1 of 2 .31 • ' Public Health Law Sec. 4145(2b) 4 e • Receipt Human remains of . - delivered on , 20 Pine View Cemetery Representirig the funeral home named on burial permit Official Funeral Directors Reg.or License# '