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Foster, Barbara Jeannine tt 37 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Per it Bureau of Vital Records Name First Middle Last Sex Barbara Jeannine Foster Female Date of Death Age If Veteran of U.S.Armed Forces, 04/24/2021 70 Years War or Dates H Place of Death Hospital,Institution or pZ City,Town or Village Hudson Falls Village Street Address 3 Boulevard 108,Hudson Falls Village,New York 12839 Manner of Death ©Natural Cause Accident ❑Homicide El Suicide 0 Undetermined 0 Pending W 0 Circumstances Investigation Q Medical Certifier Name Title Robert Love MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Hudson Falls Village 5726 7 ElBurial Date Cemetery,Crematory or Facility Name E Entombment 04/27/2021 Pine View Crematorium Address ElCremation Queensbury Town,New York Donation ZRemoval Date Place Removed H and/or and/or Held - Hold Address 0 Cl)a Li Transportation Date Point of a by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address ElReinterment 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 N 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 Cynthia Bardin(Electronically Signed) (signature) District Number 5726 Place Hudson Falls Village, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 1— Z Date of Disposition yin i-1,/ Place of Disposition ILI 2 /a dress) W N CC (section) (/ot n/u ber) (grave number) o Name of Sexton or Person in Charge of Premis / A ram, Z /�� (p/eYase print) W Signature Ems' Title /67 "ilTq DOH-1555(07/18)p 1 of 2 1 r Public Health Law Sec. 4145(2b) 01 t17 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#