Loading...
Ross, Tiffany Lorraine /OF /4 7 (0 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Tiffany Lorraine Ross Female Date of Death Age If Veteran of U.S.Armed Forces, 03/31/2022 40 Years War or Dates Place of Death Hospital,Institution or ZCity,Town or Village Albany Street Address Albany Medical Center Hospital `p Manner of Death II Natural Cause Accident Homicide DSuicide nUndetermined Pending Circumstances nvestigation Q Medical Certifier Name Title Teresa Caringi NP Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 0806 Burial Date Cemetery,Crematory or Facility Name 04/04/2022 Pine View Crematorium Entombment Address Cremation Queensbury Town,New York Donation 0 ElRemoval Date Place Removed and/or and/or Held Hold Address CO 4. Date Point of fA Transportation 3 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 H Remains are Shipped,If Other than Above 2 Address IC W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/04/2022 Registrar of Vital Statistics DDaniel:a S C iQespie gCectronically Signed) /signature) District Number 0101 Place City Of Albany I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition 7 7--2 7Z Place of Disposition 7,�)e 1 e ' Cre c,'-49 f1 2 (address) W (/) Q (section) (lot number) (grave number) Name of Sexton or Person in Charge f Premi es Rili/i©" 6 `wD� Z (please print) W Signature Title �) �'1i' DOH-1555(07/18)pi of 2 !� 5P47 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#