Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Travers, Jean F.
- Z So NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records t I Sex Name First Middle Las Female Jean F Travers Date of Death I Age If Veteran of U.S.Armed Forces, 08/06/2021 86 Years War or Dates Place of Death Hospital,Institution or ~E City,Town or Village Queensbury TownStreet Address Glens Falls Center for Rehabilitation and Nursing ❑Undetermined �Pending pManner of Death ©Natural Cause Accident Homicide Suicide Circumstances Investigation W W Medical Certifier Name Title o Michael Miles MD Address 152 Sherman Ave,Queensbury Town,New York 12801 Death Certificate Filed 1 Register Number District Number 1 Queensbury City,Town or Village 5657 61 El Burial Date Cemetery,Crematory or Facility Name 08/07/2021 Pine View Crematory ElEntombment Address ElCremation Queensbury Town,New York Donation Date Place Removed OCI Removal and/or Held F= Holddand/orAddress co per, Date Point of CO Transportation Shipment S by Common Carrier Destination Date Cemetery Address ElDisinterment Date Cemetery Address Reinterment I Registration Number Permit Issued to 01443 Name of Funeral Home Regan Denny Stafford Funeral Home Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above a Address IC W n' Permission is hereby granted to dispose of the human remains described above as indicated. 08/06/2021 Registrar of Vital Statistics Caroline x(fegarcfe Barber(EfectronicalTy Signed) Date Issued g (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 H 11.— et--...... laDate of Disposition V I9111 Place of Disposition (address) W (lot number) t (grave number) Cl)Ir (section/ 1 O i+c O Name of Sexton or Person in Cha f Premises (pleas rint) r �y� UJ Title 4lr W Signature DOH-1555(07/18)p 1 of 2 • Public Health Law Sec. 4145(2b) '"y' ' �` `'" Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#