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Younes, Joan Laurel 11 1osZ NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records . Name First Middle Last Sex Joan Laurel Younes Female Date of Death Age If Veteran of U.S.Armed Forces, 12/01/2021 77 Years War or Dates E._ Place of Death Hospital,Institution or W City,Town or Village Horicon Town Street Address 178 Duell Hill Road, Horicon Town,New York 12815 p Manner of Death ©Natural Cause ElAccident 0 Homicide 0 Suicide 0 Undetermined El Pending W U Circumstances Investigation Ui Medical Certifier Name Title Ci Ryan Donnelly DO Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Brant Lake 5654 / 10 Burial Date Cemetery,Crematory or Facility Name 12/07/2021 Pine View Crematory 0 Entombment Address ElCremation Queensbury Town,New York ' EiDonation - O Removal Date Place Removed and/or and/or Held H Hold Address to 0 O. Date Point of V) Li Transportation O by Common Shipment Carrier Destination II Disinterment Date Cemetery Address EIReinterment 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 1— Remains are Shipped,If Other than Above • Address C W n' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/07/2021 Registrar of Vital Statistics 'Krista G`Woor!("ElectronicallySigned) (signature) District Number . 5654 Place Brant Lake, New York • I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 1— �J W Date of Disposition I Z I Ci I ti Place of Disposition f a tt/t� ZATY4.--.. 2 (a dress) W CCCC /section/ A(tot number/ (grave number/ O Name of Sexton or Person in Charge of Premises t '► ��i� --- Z / /� (pleasrint) Ill Signature Title v M b4 I��� DOH-1555(07/18)p t of 2 ,J 1. 70 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#