Loading...
Flower, Joyce Rose tc NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Joyce Rose Flower Female Date of Death Age If Veteran of U.S.Armed Forces, 12/30/2021 74 Years War or Dates 1986-1991 F— Place of Death Hospital,Institution or Z City,Town or Village Queensbury Town Street Address 30 Sunnyside North,Queensbury Town, New York 12804 LU p Manner of Death © Natural Cause ❑Accident ❑Homicide Ei Suicide ❑Undetermined 0 Pending W U Circumstances Investigation W Medical Certifier Name Title 0 Robert Reeves MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 5657 257 Burial Date Cemetery,Crematory or Facility Name 01/05/2022 Pine View Crematorium Entombment Address ElCremation Queensbury Town,New York Donation Z Removal Date Place Removed 0 Eland/or and/or Held H Hold Address N 0 11 Date Point of (I) L j Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom u— Remains are Shipped,If Other than Above 2 Address IX W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/01/2022 Registrar of Vital Statistics Caroline xlrfegarcfe Barber(Efectronicatty Signed) (signature) District Number 5657 Place Queensbury, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z IL W Date of Disposition I f 7 /ZZ Place of Disposition Li.: �,L_. 4-er,............ 2 (address) W N OC (section) lot number) (grave number) 0 Name of Sexton or Person in Charge of Pr mises C a ts-- . 6.1"Lfrd � pleat) Z �1“V e W Signature r Title r �(� DOH-1555(07/18)p i of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named op burial permit Official Funeral Directors Reg. or License#