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Stranahan, Merwin Sidney NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Merwin Sidney Stranahan Male Date of Death Age If Veteran of U.S.Armed Forces, 12/04/2021 77 Years War or Dates 1964-1966 Place of Death Hospital,Institution or IZ City,Town or Village Glens Falls Street Address Glens Falls Hospital 0 Manner of Death © Natural Cause 0 Accident El Homicide El Suicide El Undetermined 0 Pending W C.) Circumstances Investigation W Medical Certifier Name Title 0 Shahid Ahmed MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 580 ElBurial Date Cemetery,Crematory or Facility Name 12/10/2021 Pine View Cemetery 0 Entombment Address ElCremation Queensbury Town,New York 0 Donation Z Removal Date Place Removed 0 and/or and/or Held �- Hold Address 0 0. Date Point of t/) ❑Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/07/2021 Registrar of Vital Statistics 796ertAndrew Curtis(ECectronicaIIy 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: WDate of Disposition 12 .10 .21 Place of Disposition 21 Quaker Rd. Queensbury, NY 12804 2 (address) W Horicon 31A 1 CC CC (section) (lot number) (grave number) O• Name of Sexton r Person in Charge of Premises Connie Goedert (please print) W �_d Title Superintendent Signature DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 012886 Receipt Human remains of- - ti6 ' delivered on , 20T: ( Pine View Cemetery Ilepiesenting the funeral home named on burial permit Official Funeral Directors Reg.or License# /- 1 / - STRANAHAN NAME Merwin Sidney Stranahan Age:77 Lot Owner: Susan Stranahan Lot# Horicon 31 A Grave# 1 Case: Concrete Died: 1 2.4.21 Interred:: 2. 1 0.21 • Funeral Home: Baker FH Cemetery: Pine View