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Soward, Margaret 357 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Margaret Soward Female Date of Death Age If Veteran of U.S.Armed Forces, 04/18/2021 100 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Malta Town Street Address 26 Rockrose Way,Malta Town,New York 12020 W Manner of Death © Natural Cause Li Accident ElHomicide El Suicide ❑Undetermined ❑Pending U Circumstances Investigation ILI Medical Certifier Name Title Madison Zuis NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Malta 4560 24 ElBurial Date Cemetery,Crematory or Facility Name 04/20/2021 Pine View Crematory ElEntombment Address Cremation Queensbury Town,New York ElDonation Z Removal Date Place Removed and/or and/or Held F Hold Address 0 Q. Date Point of U) ❑Transportation El 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 Remains are Shipped,If Other than Above M Address CC W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/19/2021 Registrar of Vital Statistics 9ennifer Marie Names(ECectronicalry Signed) (signature) District Number 4560 Place Malta, 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 LJ//J)/7 Place of Disposition - 1L g address) W CC (section) otnumber/ (grave number) • 0 Name of Sexton or Person in Charge of Premises G " !'f th A4, (please41V, nt) W Signature � — Title CK-4" v DOH-1555(07/18)p 1 of 2 1 Public Health Law Sec. 4145(2b) -4 Receipt Human remains of _ `), delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#