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Bigelow, Sandra Edith NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Sandra Edith Bigelow Female Date of Death Age If Veteran of U.S.Armed Forces, 02/14/2022 78 Years War or Dates f. Place of Death Hospital,Institution or Z City,Town or Village Hudson Falls Village Street Address 109 Maple Street, Hudson Falls Village, New York 12839 p Manner of Death © Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title p Mary Stein NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Hudson Falls Village 5726 6 ❑Burial Date Cemetery,Crematory or Facility Name 02/16/2022 Pine View Crematory ❑Entombment Address X❑Cremation Queensbury Town,New York ❑Donation 0 El Removal Date Place Removed and/or and/or Held Hold Address N 0 N ❑Transportation Date Point of El Common Shipment Carrier Destination Date Cemetery Address ❑Disinterment ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom f.- Remains are Shipped,If Other than Above 2 Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/15/2022 Registrar of Vital Statistics Cynt(tiaA Bardin(E(ectronica1TySigned) (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: IH Z Date of Disposition 2/l x lZ Place of Disposition 47n ,1l(j -- W 2 (address) W N CC (section) (lot number) C (grave number) ciName of Sexton or Person in Charge of Premis ro �• Z (plea e print) W Signature Title I DOH-1555(07/18)p t 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#