Loading...
Lennox, Elizabeth Cathryn 23 NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Elizabeth Cathryn Lennox Female Date of Death Age If Veteran of U.S.Armed Forces, 02/28/2021 90 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death © Natural Cause 11 Accident Homicide Suicide ❑Undetermined Pending W Circumstances Investigation WMedical Certifier Name Title O Scott Biasetti MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 121 Burial Date Cemetery,Crematory or Facility Name 03/01/2021 Pine View Crematory Entombment Address X❑Cremation Queensbury Town,New York ❑Donation ❑Removal Date Place Removed and/or and/or Held ~ Hold Address CO 0 a* Date Point of U) Li Transportation `l by Common Shipment Carrier Destination Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls, New York 12803 Name of Funeral Firm Making Disposition or to Whom fr Remains are Shipped,If Other than Above Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/01/2021 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 3/4 ill Place of Disposition L 2 (address) W (section) A (lot umber) (grave number) ZO Name of Sexton or Person in Charge of Pre ises G �=t `' c\I.%�.4k (pleas print) / ,�; 1 W Signature Lam^ Title G h "��" DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) C 598 Receipt Human remains of delivered on ' I , 20 a Y f Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#