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Welch, Gloria Jean
., ... e ,4- _ 370 NEW YORK STATE DEPARTMENT OF HEALT Burial - Transit Permit Bureau of Vital RecordsAl Name First MIlir Last Sex Gloria Jean Welch Female Date of Death Age I1 Vetera 7.t.'.Armed Forces, 04/28/2022 65 Years War or Dates 1975-1977 F. Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital iLi tp V El hle Manneroi Death I INaturalCause []AccidentHomicide []Suicide []Undetermined []Pending I 1 / "Circumstances I !Investigation W Medical Certifier Name © Mathew Varughese `� DO Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number Chy,Town or Village 5601 239 IllBurial Date Cemetery,Crematory or Facility Name []Errtv inhale rr! p5/09(2°22 Pine View Crematorium Address []Cremation Queensbury Town,New York []Donation ©❑Removal Date Place Removed arid/or and/or Held • H Hold Address to 0 O. Date Point of t/)[]transportation Shipment Q by Common Carrier Destination Date Cemetery Address ri Disinterment Date Cemetery Address ElReinterment 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 F- Remains are Shipped,It Other than Above 2 Address C IL O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/02/2022 Registrar of Vital Statistics _`Nyun i'olin(Thtmini '.S tre'f (si nafur ej 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: Zif& Z Date of Disposition sill I tZ Place of Disposition 7.rtilL__ � w (v »i w An° (wain[]' (lotuuotheit (gravE number./ QC L. ` G� Name of Sexton or Person in Charge of remses �N i /(phA seFrin(' z i#'1T111�. w Signature itle DOH-1555 l07/18's p t of 2 +or' 1 5c9 x 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#