Loading...
Brainard, Linda L it 5-0 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit ss Bureau of Vital Records Name First Middle Last Sex Linda L.Brainard Female Date of Death Age If Veteran of U.S.Armed Forces, 06/16/2021 78 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital 'p Manner of Death © Natural Cause ❑Accident 0 Homicide ❑Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title G Sarah Durkee PA Address 9 Carey Road,Queensbury Town, New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 252 ❑Burial Date Cemetery,Crematory or Facility Name 06/18/2021 Pine View Crematory ElEntombment Address 1 Cremation Queensbury Town,New York ▪Donation o• ElRemoval Date Place Removed and/or and/or Held E-- Hold Address N 0 CL Date Point of U) ❑Transportation Q by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit.lssued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above Address OC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/17/2021 Registrar of Vital Statistics Np6ertAndrew Curtis(ECectronicaCCy 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: Ih— Z Date of Disposition LI Il 114 Place of DispositionUJ 2 (address) W U)CC (section) illot number) (grave number) 8 Name of Sexton or Person in Charge of Premises (pleas print) /� W Signature Title tee DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 01,.4 8 E 6 Receipt Human remains of delivered on , 20_ Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#