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Purner, Paul Joseph
...... ,,-. ii. (.13 _ .,f NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Paul Joseph Purner Male Date of Death Age If Veteran of U.S.Armed Forces, i 06/11/2021 84 Years War or Dates G 1._ Place of Death Hospital,Institution or • W City,Town or Village Albany Street Address Albany(Medical Center Hospital in Manner of Death ©Natural Cause El Accident ❑Homicide ❑Suici'de ❑Undetermined ❑Pending W Circumstances Investigation U W Medical Certifier Name Title CI Ahmad Choudry MO Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 1507 0 Burial Date Cemetery,Crematory or Facility Name • 06/15/2021 Pine View Crematorium 0 Entombment Address ElCremation Queensbury Town,New York ; 0 Donation Removal Date Place Removed e•nd/or and/or Held H Hold Address t) 0 G. Date Point of Cl) ❑Transportation Shipment p by Common Carrier Destination Date Cemetery Address 0 Disinterment El Reinterment 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 F.. Remains are Shipped,If Other than Above Address CC ILL! a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/14/2021 Registrar of Vital Statistics cDanieCCe S gilespie(ECectronicafy Signed) (signature) District Number 0101 Place Albany, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Z Date of Disposition (,igVj.4 Place of Disposition o..� dk Ili 2 ad ress) W CCCC (section) I number) _ (grave number) gName of Sexton or Person in Charge of Pr ises Ill 1.1 �"a-. AAA- Z (please ph►nt) W Signature Z Title CP014147N DOH-1555(07/18)p 1 of 2 1 I Public Health Law Sec. 4145(2b) a 14 6 0 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#