Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Woodcock, Laurie Ann
)-3 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Laurie Ann Woodcock Female Date of Death Age If Veteran of U.S.Armed Forces, 12/27/2020 48 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital 'p Manner of Death © Natural Cause 1=1 Accident ElHomicide ElSuicide ❑Undetermined Pending V Circumstances Investigation Q Medical Certifier Name Title Sean Bain MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 600 Burial Date Cemetery,Crematory or Facility Name 12/30/2020 Pine View Crematory ❑Entombment Address X❑Cremation Queensbury Town,Warren,New York ❑Donation O Removal Date Place Removed and/or and/or Held F. N Hold Address 0 O.UU) ❑Transportation Date Point of p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom F Remains are Shipped,If Other than Above 2 Address LE a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/30/2020 Registrar of Vital Statistics cR 6ertAnrfrew Curtis(Electronicaf(y Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition /Z-31 70U Place of Disposition JiYi c�1 Ati-e4� /// c-/ _ <<;/`� UJ (addre s) ILLI CC CC (section) V (lot number) (grave number) • Name of Sexton or Perso n Charge of Premises t" /�G•1`l please P in Z W Signature Title 'p yK� �y DOH-1555(o7/18)p 1 of 2 Public Health Law Sec. 4145(2b) ti!� Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#