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Murphy, Verna Louise # i Cr NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records :_ Name First Middle Last Sex .,;ti, Vema Louise Murphy Female ° Date of Death Age If Veteran of U.S.Armed Forces, 03/05/2021 86 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Saratoga Springs Street Address Saratoga Hospital Manner of Death © Natural Cause El Accident I=1 Homicide El Suicide 0 Undetermined Pending Circumstances Investigation 0 Medical Certifier Name Title Derek Smith MD r Address 211 Church St,Saratoga Springs,New York 12866 • Death Certificate Filed District Number Register Number City,Town or Village Saratoga Springs 4501 182 Burial Date Cemetery,Crematory or Facility Name 03/08/2021 Pine View Crematory ;. El Entombment Address ,ar'' Eu Cremation Queensbyry Tpwn,New York ,;❑Donation Removal Date Place Removed and/or and/or Held Hold Address Transportation Date Point of by Common Shipment Carrier Destination . _:t Date Cemetery Address � t 1 "'Li Disinterment • ❑Reinterment Date Cemetery Address • Permit Issued to Registration Number 1� ,: Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 A• ddress 123 Main St,Argyle,New York 12809 .;.• Name of Funeral Firm Making Disposition or to Whom ` R• emains are Shipped,If Other than Above Address C ti a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/05/2021 Registrar of Vital Statistics John Pau(Eranck(ECectronicalty Signed) R,; (signature) District Number 4501 Place Saratoga Springs, New York '' I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 3��p 7� Place of Disposition `I r�� Apr.-'. w (address) UI (section) (lot number) (grave number) 2' Name of Sexton or Person in Charge of Premise ""ti 3"""�1Q Z ��� �� (p/easeVarint) W �%�' �/' Title F%�'''"tFJvt' Signature DOH-1555(07/18)p i of 2 Public Health Law Sec. 4145(2b) 014 2 Receipt Human remains of a delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#