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Aubrey, Donita Elaine 211 NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Donita Elaine Aubrey Female Date of Death Age If Veteran of U.S.Armed Forces, ,:'� 03/31/2022 66 Years War or Dates + Place of Death #�' Hospital,Institution or W' City,Town or Village Argyle Town Street Address 130 Sweet Road,Argyle Town,New York 12809 Manner of Death ❑X Natural Cause Accident ❑Homicide 0Suicide El Undetermined ❑Pending j Circumstances Investigation U.I Medical Certifier Name Title ©; Robert Lemieux Coroner Address ,, 415 Lower Main Street,Hudson Falls Village,New York 12839 Death Certificate Filed Town Of Argyle District Number Register Number City,Town or Village 5750 11 Burial Date Cemetery,Crematory or Facility Name 04/04/2022 Pine View Crematory Entombment Address . Cremation Queensbury Town,New York go Donation Removal Date Place Removed H and/or and/or Held N Hold Address 0 a Date Point of Transportation p by Common Shipment Carrier Destination Date Cemetery Address ❑DisintermentEI 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 • Remains are Shipped,If Other than Above 2 Address W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/04/2022 Registrar of Vital Statistics Shelley rMckernon(ECectronicalTySigned) (signature) District Number 5750 Place Town Of Argyle I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ////�� W" Date of Disposition alit ZZ Place of Disposition E.711 2 /address) IA m. (section) (lot number (grave number) 0 Name of Sexton or Person in Cha a of Premises ?i^— �� (please print) tllJ Signature Title CA v1O1— DOH-1555(07/18)p 1 of 2 15943 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#