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Hobbs, Sandra Lee ` '- r 41 3-) NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Sandra Lee Hobbs Female Date of Death Age If Veteran of U.S.Armed Forces, 04/23/2021 74 Years War or Dates F Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death Undetermined Pending W ©Natural Cause Accident Homicide Suicide Circumstances Investigation W• Medical Certifier Name Title O Kyle Leonard MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 191 ElBurial Date Cemetery,Crematory or Facility Name 04/26/2021 Pine View Crematorium ❑Entombment Address ElCremation Queensbury Town,New York ❑Donation ZO ❑Removal Date Place Removed and/or and/or Held H Hold Address 0 CL Date Point of co ❑Transportation p by Common Shipment Carrier Destination Disinterment 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 i.. Remains are Shipped,If Other than Above M Address CC w a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/26/2021 Registrar of Vital Statistics &6ertAndrew Curtis(E(ectronica1Ty Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition q JZ$/Zi Place of Disposition gh u :tat'.---... 2 (address) III CC CCc(section) (lot number) (grave number) L] Name of Sexton or Person in Charge of Pre ises r.s\p L 5 t n.4t z (p a se print) LU Signature L-�(' Title CP.M r} DOH-1555(07/18)p t of 2 Public Health Law Sec. 4145(2b) U 14 7 4 3 Receipt Human remains of delivered on `� , 20 Pine View Cemetery kepresenting the funeral home named on burial permit Official Funeral Directors Reg.or License#