McNeil, Loren James Jr. LF
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vitat Records
, Name First Middle Last Sex
Loren James McNeil Jr Male
Date of Death Age If Veteran of U.S.Armed Forces,
04/12/2022 86 Years War or Dates
Place of Death Hospital,Institution or
tLL City,Town or Village Glens Falls Street Address Glens Falls Hospital
0 Manner of Death [11 Natural Cause Accident I (Homicide 0Suicide Undetermined nPending
W U Circumstances f 'Investigation
W Medical Certifier Name Title
G William Cleaver MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 212
Burial Date Cemetery,Crematory or Facility Name
®' 04/14/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
0Z❑Removal Date Place Removed
and/or and/or Held __
CO
Hold Address
0
CL Date Point of
Cl)111Transportation Shipment
Q by Common
Carrier Destination
Date Cemetery Address
Disinterment
Date Cemetery Address
Reinterment
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
H Remains are Shipped,If Other than Above
M Address
Cr
f1
41' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/13/2022 Registrar of Vital Statistics Megan Wolin(ECectronica1TySigned)
(signature)
District Number 5601 Place City Of Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H /
Date of Disposition �^/V'2v22 Place of Disposition p,h e.%,+i'I,c./ ar2,yle+l'
UJ
2 (address
ti
Cr (section) J (lot number) (grave number)
4 rw I .c..✓t 4'4.0,1 a L l.-G-
0 Name of Sexton or Person' Charge of Premises
(please print)
11J Signature Title Gr p/y ey@/ G`'
DOH-1555(07/18)p i o 2
Public Health Law Sec. 4145(2b)
I Receipt \,
1 K
t , II^; k
Human remains of ` " ° ` delivered on , 20
i r
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# 's•-)