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Wubbolt, Linda i ,---, - , it pig NEW YORK STATE DEPARTMENT OF HEALTH _�. "" y- Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Linda Wubbolt Female Date of Death Age If Veteran of U.S.Armed Forces, 12/13/2021 58 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital pManner of Death 0 Natural Cause EjAccident El Homicide El Suicide 0 Undetermined ©Pending W Circumstances Investigation W Medical Certifier Name Title O Timothy Murphy Coroner Address 52 Haviland Avenue,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls r 5601 597 ElBurial Date Cemetery,Crematory or Facility Name 12/15/2021 Pineview Crematorium ElEntombment Address • 0 Cremation Queensbury Town,New York ElDonation ZZ El Removal Date Place Removed i= and/or and/or Held " Hold Address O 0. Date Point of fA �Transportation Shipment S by Common Carrier Destination Disinterment Date Cemetery Address El Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Radloff Funeral Home Inc 01425 Address 136 Warren St,Glens Falls,New York 12801 Name of Funeral Firm Making Disposition or to Whom 1.. Remains are Shipped,If Other than Above a Address IC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/15/2021 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: Date of Disposition Y2in Li( Place of Disposition ,Y � d-✓�Lit ' �raddress) W it (section) (rot number) S- (grave number) Name of Sexton or Person in Charge of Premises (t ' ' 4S (p/ese print) W riff- Signature /1 `/� Title triF DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) >oft '315447 Receipt A Human remains of • ' t ( 't-tr ' '•11 ' delivered on ' , 20 Pine View Cemetery Representing the funeral home namedou,buriApermit Official Funeral Directors Reg.or License#