Plummer, Linda Mae r
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NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Linda Mae Plummer Female
Date of Death Age If Veteran of U.S.Armed Forces,
05/09/2022 74 Years War or Dates
F— Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address Glens Falls Hospital
ILI
p Manner of Death El Natural Cause Accident Homicide Suicide ❑Undetermined Pending
W
C.) Circumstances Investigation
W Medical Certifier Name Title
0 Asim Chaudry MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
Ci ,Town or Village 5601 260
Burial Date Cemetery,Crematory or Facility Name
05/11/2022 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
ZO❑Removal Date Place Removed
and/or and/or Held
H Hold Address
N
0
O. Date Point of
CO ETransportation Shipment
p by Common
Carrier Destination
El
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
IX
W
EL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 05/11/2022 Registrar of Vital Statistics Megan Nolin(ECectronica1y Signed)
(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:
Z L L___
W Date of Disposition s�l�I j'Z Place of Disposition r
2 addris)
W
Cl)CC (section) (I number) x (grave number)
g Name of Sexton or Person in Charg Premises
. 0 t SU
(pl se print)
W Signature Title 1uve
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#