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Wright, Gladys NEW YORK STATE DEPARTMENT OF HEALTH (17.--� Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Gladys Wright Female Date of Death Age If Veteran of U.S.Armed Forces, 04/27/2021 98 Years War or Dates ZZ Place of Death Hospital,Institution or UJ City,Town or Village Queensbury Town Street Address Glens Falls Center for Rehabilitation and Nursing p Manner of Death ©Natural Cause 0 Accident ❑Homicide 0 Suicide El Undetermined 0 Pending W CICircumstances Investigation Q Medical Certifier Name Title Wendy Steinhacker PA Address 152 Sherman Ave,Queensbury Town,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 5657 100 ©Burial Date Cemetery,Crematory or Facility Name 04/27/2021 Pine View Cemetery ❑Entombment Address ❑Cremation Queensbury,New York ❑Donation Z Removal Date Place Removed - and/or and/or Held N Hold Address O U ❑Transportation Date Point of ES by Common Shipment Carrier Destination Disinterment Date iCemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above a Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/27/2021 Registrar of Vital Statistics Caroline Jfi((egarrle Barber(E(ectronicallySigned) (signature) District Number 5657 Place Queensbury, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I- Z Date of Disposition 4/27/2021 Place of Disposition 21 Quaker Rd. Queensbury, NY 12804 iu 2 (address) IW Huron 12 G 1 N Cr (section) (tot number) (grave number) 8 Name of Sexton o erson in Charge of Premises Connie Goedert Z (please print) W Signature &41, Title Superintendent DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 012853 Receipt 1 I Human remains of t i - delivered on >-4f , 20;; j I Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# / =,l.,,, I WRIGHT NAME Gladys Wright Age: 98 Lot Owner: Gladys Wright Lot# Huron 12 G Grave# 1 Case: Concrete Died: 4/27/2021 Interred: 4/27/2021 Funeral Home: Regan Denny Stafford Cemetery: Pine View �J'