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Edwards, Pamela Iola # l yk NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Pamela Iola Edwards Female Date of Death Age If Veteran of U.S.Armed Forces, 02/12/2022 58 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Hudson Falls Village Street Address 115 John Street, Hudson Falls Village, New York 12839 W Manner of Death ©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation E Medical Certifier Name Title Alexandra Aarons MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Hudson Falls Village 5726 4 Burial Date Cemetery,Crematory or Facility Name 02/15/2022 Pine View Crematorium ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation ❑Removal Date Place Removed and/or and/or Held H Hold Address 0 0. Date Point of CA ❑Transportation s by Common Shipment 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 1— Remains are Shipped,If Other than Above 2 Address CC W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/14/2022 Registrar of Vital Statistics CynthiaA Bardin(Electranicafy Signed) (signature) District Number 5726 Place Hudson Falls Village, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 21Ib t2z Place of Disposition ukk (address) W Q (section) /lotnumbe (grave number) SName of Sexton or Person in Charge of Premises L -Sv'J ft Z �(p/ease print) W Signature Title rag DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on _ , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#