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Felt, Raymond Alvin Sr.
LOF . 41 NEW YORKSTATE DEPARTMENT OF HEALTH �r) Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Raymond Alvin Felt Sr. Male Date of Death Age If Veteran of U.S.Armed Forces, 01/06/2022 90 Years War or Dates 1952-1954 i_ Place of Death Hospital,Institution or W City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare 0 Manner of Death © Natural Cause El Accident El Homicide El Suicide 0 Undetermined El Pending W U Circumstances Investigation nW Medical Certifier Name Title Joshua Starteri NP Address 4573 State Route 40,Argyle Town,New York 12809 Death Certificate Filed District Number Register Number City,Town or Village Argyle 5750 1 ❑Burial Date Cemetery,Crematory or Facility Name 01/12/2022 Pine View Crematory El Entombment Address ElCremation Queensbury Town,New York ElDonation 1:1Removal Date Place Removed F and/or and/or Held N Hold Address 0 (/) Transportation Date Point of CI by Common Shipment Carrier Destination 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 i- 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 01/12/2022 Registrar of Vital Statistics Shelley Mckcrnon(ElectronicallySigned) (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: z /"/ 111 Date of Disposition 111�Ill_ Place of Disposition �/, / yE„�`` WI (address)"` U) C (section) (lot number) (grave number) Q Name of Sexton or Person in Charge of Pr ises �j mIt__ ,vlil-W ( se print)Signature Title C 9n'YI DOH-1555(07/18)p id 2 CI C Public Health Law Sec. 4145(2b) Receipt 1 Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#