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McKittrick, Marjorie Patricia NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Marjorie Patricia McKittrick Female Date of Death Age If Veteran of U.S.Armed Forces, 03/03/2021 75 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital faManner of Death ©Natural Cause Accident D Homicide ❑Suicide Undetermined ❑Pending Circumstances Investigation LU Medical Certifier Name Title 0 Ibrahim El Halabi MD Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 0680 ❑Burial Date Cemetery,Crematory or Facility Name 03/08/2021 Pine View Crematorium ❑Entombment Address 0 Cremation Queensbury Town,New York 0 Donation Z Date Place Removed Removal and/or and/or Held H Hold Address 0 Date Point of Cl) ❑Transportation p by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom .- Remains are Shipped,If Other than Above Address W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/08/2021 Registrar of Vital Statistics Danielle S giCCespie(ECectronicafy Signed) (signature) District Number 0101 Place Albany, 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 3^9-201-1 Place of Disposition p e_/Qr /y 2 (address) ILI CC CC (section) (lot number) (grave number) 8 Name of Sexton or Per in C of P mises �^ r a-K ( �- Z (please print) LtJ Signature Title �ta,.ht/� Opt DOH-1555(07/18) 1 of 2 Public Health Law Sec. 4145(2b) M 3.4 61 •t Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#