Loading...
Wurzer, Janina Anne NEW YORK STATE DEPARTMENT OF HEALTH ` ~ Burial - Transit Per it Bureau of Vital Records Name First Middle Last Sex Janina Anne Wurzer Female Date of Death Age If Veteran of U.S.Armed Forces, 08/17/2021 76 Years War or Dates F. Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital LU p Manner of Death © Natural Cause 0 Accident El Homicide 0 Suicide ❑Undetermined 0 Pending W C.) Circumstances Investigation W Medical Certifier Name Title CI Julian Marynczak PA Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 343 0 Burial Date Cemetery,Crematory or Facility Name 08/19/2021 Pine View Crematory 0 Entombment Address 0 Cremation Queensbury Town,New York 0 Donation Z• Removal Date Place Removed and/or and/or Held F— Hold Address N 0 Date Point of Cl) ❑Transportation Shipment Q by Common Carrier Destination Date Cemetery Address ❑Disinterment El Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom F... Remains are Shipped,If Other than Above 2 Address Q W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/18/2021 Registrar of Vital Statistics Robert Andrew Curtis(Electronically 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: W �Date of DispositionI li 1 Place of Disposition ` 1 (address) W N (section) /J(lot number) (grave number) 0 Name of Sexton or Person in Charge of P mises At 11 z41 (plea print) SignatureILI a...0.7. Title DOH-1555(07/18)p 1 of 2 . � .. 0 5051 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing thC funeral home named on b.rial permit Official Funeral Directors Reg.or License#