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McLean, Donald Charles
0 l 06s-- NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Donald Charles McLean Male Date of Death Age If Veteran of U.S.Armed Forces, 12/05/2021 89 Years War or Dates 1948-1952 H Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death © Natural Cause ❑Accident ❑Homicide Suicide ID Undetermined ❑Pending W U Circumstances Investigation W Medical Certifier Name Title CI Sean Bain MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 576 ❑Burial Date Cemetery,Crematory or Facility Name 12/13/2021 Pine View Crematory ❑Entombment Address ElCremation Queensbury Town,New York ❑Donation Z Removal Date Place Removed and/or and/or Held H Hold Address N 0 a. Date Point of U) ❑Transportation Shipment p by Common Carrier Destination EIDisinterment Date Cemetery Address EiReinterment 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 1— Remains are Shipped,If Other than Above 2 Address Q W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/06/2021 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: I— Z Date of Disposition 111 t3 12l Place of Disposition �n tUt� r,J`_. W (a dress) W CC (section) t lot number) S (grave number) 0 Name of Sexton or Person in Charge of Premises it.... s~�� O (plprint) W Signature g Z Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 1 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#