Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Duel, Susan J
it NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Susan J Duell Female Date of Death Age If Veteran of U.S.Armed Forces, 05/12/2021 74 Years War or Dates l` Place of Death Hospital,Institution or Z-City,Town or Village Glens Falls Street Address The Pines At Glens Falls Center For Nursing&Rehabilitation O Manner of Death Natural Cause Accit Homicide 1=1Suicide Undetermined Pending ✓ © 0 denCircumstances Investigation W Medical Certifier Name Title O Courtney Diamond NP Address 170 Warren St,Glens Falls,New York 12801 Death Certificate Filed it, District Number Register Number City,Town or Village Glens Falls 5601 213 ❑Burial Date Cemetery,Crematory or Facility Name 05/15/2021 Pine View Crematory ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation Z• Removal Date Place Removed and/or and/or Held pN Hold Address 0 0. Date Point of CO Li Transportation Shipment a by Common Carrier Destination Disinterment Date Cemetery 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 2 Address CC W 0. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/14/2021 Registrar of Vital Statistics W96ertAndrew Curtis(Efectronicaffy 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 permiton: Z W Date of Disposition g]It(( Z( Place of Disposition lf-11 4"--- 2 (address) W NCC (section) Rot',imbed (grave number) L K. 0 Name of Sexton or Person in Charge of Pr ises �` � "� Z (please print)V W Signature �'' Title l��'"al�+C g DOH-1555(07/18)p 1 of 2 IPublic Health Law Sec. 4145(2b) 'J 14791, Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# rr _ P•►.