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Torda, Virginia Lee NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Virginia Lee Torda Female Date of Death Age If Veteran of U.S.Armed Forces, 12/15/2021 81 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Argyle Town Street Address 4786 State Rte 40,Argyle Town, New York 12809 O Manner of Death © Natural Cause ❑Accident ❑Homicide El Suicide ❑Undetermined Pending U Circumstances Investigation W Medical Certifier Name Title CI Sherie O'connell PA Address 377 Spring Road,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City,Town or Village Argyle 5750 77 ElBurial Date Cemetery,Crematory or Facility Name 12/17/2021 Pine View Crematory ❑Entombment Address iCremation Queensbury Town,New York ❑Donation 0 Removal Date Place Removed and/or and/or Held F.Fr) Hold Address 0 d. Date Point of co ❑Transportation p by Common Shipment Carrier Destination El Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 Address 123 Main St,Argyle,New York 12809 Name of Funeral Firm Making Disposition or to Whom E . 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 12/17/2021 Registrar of Vital Statistics Shelley Mckernon(Electronically Signed) (signature) District Number 5750 Place Argyle, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition )�/-z, r/ Place of Disposition Ct yi&4v' --k (address/-4 W N Cr (section) (lot nujer) (grave number) 0 Name of Sexton or Person in C ge of Premiss Ic74 Y'1410- L tiPaci z (please print) W Signature / 4/ Title �e90►4z7' DOH-1555(o7/t8)p t of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 i Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#