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Robbins, Virginia Gibson
1713 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Virginia Gibson Robbins Female Date of Death Age If Veteran of U.S.Armed Forces, 02/03/2021 87 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital 1p Manner of Death © Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title fa Matthew Loftus PA Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 81 ❑Burial Date Cemetery,Crematory or Facility Name 02/05/2021 Pine View Crematory ❑Entombment Address ElCremation Queensbury Town,New York ❑Donation 0 ❑Removal Date Place Removed and/or and/or Held us Hold Address 0 O. Date Point of U) ❑Transportation p by Common Shipment Carrier Destination El Disinterment Date Cemetery Address Date Cemetery Address ❑Reinterment Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 Address 123 Main St,Argyle, New York 12809 Name of Funeral Firm Making Disposition or to Whom �... Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/05/2021 Registrar of Vital Statistics Men Andrew Curtis WectronicattySigned) (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: ar„_W Date of Disposition 24 fit/ Place of Disposition �f' , f L (address) W CC (section) /Act number/ (grave number) Name of Sexton or Person in Charge of Pre ises __Lot Z (p/eaS,print) W Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) .14 5 n Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#