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McFarland, Diana Margarert it5111 NEW YORKSTATE DEPARTMENT OF HEALTH Arliv Burial - Transit Permit Bureau of Vital Records Name First Middle ; Last Sex Diana Margaret McFarland Female Date of Death Age If Veteran of U.S.Armed Ford; 07/01/2021 75 Years War or Dates Place of Death Hospital;Institution or Z City,Town or Village Queensbury Town Street Address 9 Amy Lane,Queensbury Town,New York 12804 pManner of Death ©Natural Cause El Accident El Homicide El Suicide DUndetermined El Pending W Circumstances Investigation Medical Certifier Name Title 0 William Tedesco MD Address 309 COUNTY ROUTE 47 Box 840 Ste 7po,Saranac Lake,New York 12983 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 5657 137 ❑Burial Date Cemetery,Crematory or Facility Name 07/06/2021 Pine View Crematory ❑Entombment Address O Cremation Queensbury Town,New York ❑Donation 0 Removal Date Place Removed and/or and/or Held N - Hold Address 0 Date Point of (/) ❑Transportation Shipment a- by Common Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued 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 1— Remains are Shipped,If Other than Above Address CC W CI. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/06/2021 Registrar of Vital Statistics Caroline Hi(fegardeBar6er(ECectronicallySigned) (signature) District Number 5657 Place Queensbury, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z MI Date of Disposition 7 $I 'j,, Place of Disposition �n t 2 (address) W C (section) 4 number) (grave number) O; Name of Sexton or Person in Charge of Pre ises IL �' �'^ � (ple print) f w G H Signature Title 9 DOH-1555(07/18)p 1 of 2 I F Public Health Law Sec. 4145(2b) n14912 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burialfermit Official Funeral Directors Reg.or License#