Londrigan, Muriel Elaine 0
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NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Perm
Bureau of Vital Records
Name First Middle Last Sex
Muriel Elaine Londrigan Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/01/2021 91 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Glens Falls Street Address Glens Falls Hospital
• Manner of Death Jj Natural Cause ❑Accident El Homicide El Suicide L jUndetermined Pending
W Circumstances Investigation
W Medical Certifier Name Title
0 Aaron Heckler PA
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City,Town or Village Glens Falls 5601 4
Burial Date Cemetery,Crematory or Facility Name
01/05/2021 Pine View Crematory
11 Entombment Address
lCremation Queensbury Town,New York
11 Donation
Z n Removal Date Plac.. ;roved
and/or and/or He'd
H Hold Address
N
O
O. Date Point of
N �Transportation
O by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
El
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
F-. Remains are Shipped,If Other than Above
2 Address
CC
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/05/2021 Registrar of Vital Statistics p6ert lndrewCurtisgkctronically5rgned)
(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:
H
Z
Date of Disposition P f 7/ ZI Place of Disposition tom'
(address
W
CC CC (section) (1 umber) (grave number)
O Name of Sexton or Person in Charge of Pre ' es n h" f
Z p ease4int)
W Wit
Signature Title 6 �
DOH-1555(07/18)p t of 2
_
Public Health Law Sec. 4145(2b) 01 378
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#