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Knight, Lucretia Rose NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Lucretia Rose Knight Female Date of Death Age If Veteran of U.S.Armed Forces, 10/05/2021 48 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital W Undetermined Pending Manner of Death © Natural Cause �Accident Homicide �Suicide � � Circumstances Investigation W Medical Certifier Name Title CI Jacqueline Sayres PA Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 2257 ❑Burial Date Cemetery,Crematory or Facility Name 10/07/2021 Pine View Crematory ❑Entombment Address 1 Cremation Queensbury Town,New York ❑Donation ZZ ❑Removal Date Place Removed and/or and/or Held N Hold Address 0 O. Li Transportation Date Point of p by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address 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 I— Remains are Shipped,If Other than Above g Address CC W EL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/07/2021 Registrar of Vital Statistics Danielle S Gillespie(Electronically 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: Z Date of Disposition /�- -J_pl j Place of Disposition }Q I i&id (lir---/liAlokvi 2 (address) W CC 0 (section) (lot numb (grave number) I F lJac Name of Sexton or Person in Charge o Premises (p/ease print) Signature I' Title OrC,rry."X-c— DO H-1555(07/1.8)p i of 2 Public Health Law Sec. 4145(2b) 05Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# '"