Loading...
Walker, Raymond \3+i0 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Raymond Walker Male Date of Death Age If Veteran of U.S.Armed Forces, 12/22/2020 100 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital LU Manner of Death ©Natural Cause ❑Accident ❑Homicide Suicide 0 Undetermined ❑Pending W Circumstances Investigation Q Medical Certifier Name Title Stephen Perazzelli MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 593 ❑Burial Date Cemetery,Crematory or Facility Name 12/26/2020 Pineview Crematory ElEntombment Address ]Cremation Queensbury Town,New York ElDonation El ZO Removal Date Place Removed and/or and/or Held ~ Hold Address 0 a Date Point of Cl) LI Transportation p by Common Shipment Carrier Destination Date Cemetery Address ❑Disinterment Reinterment 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 E-. Remains are Shipped,If Other than Above 2 Address (Y uJ a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/24/2020 Registrar of Vital Statistics Robert Andrew Curtis(Electronically 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: W Date of Disposition /p ._ 0'140 Place of Disposition PL1 de_ Je,t.u) ei`el itik 2 (address) W CC (section) '/ / (lot number). (grave number) O▪ Name of Sexton or Person in C "rge of P es RA /rl/�i✓Q w'J� (please print) W Signature Title D ee DOH-1555(07/18)p i of 2 _ Public Health Law Sec. 4145(2b) 0 14 3 3 4 Receipt ll Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#