Robinson, Deborah Ann jt L431
f LF =.i
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Deborah Ann Robinson Female
Date of Death Age If Veteran of U.S.Armed Forces,
05/23/2022 59 Years War or Dates
F. Place of Death Hospital,Institution or
z City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare
W
W
Manner of Death Natural Cause ❑Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
W Medical Certifier Name Title
0 Joshua Starteri NP
Address
4573 State Route 40,Argyle Town,New York 12809
Death Certificate Filed Town Of Argyle District Number Register Number
City,Town or Village 5750 28_ __� _
Burial Date Cemetery,Crematory or Facility Name
05/27/2022 Pine View Crematorium
Entombment Address
oCiemation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
H Hold Address
V1
Q
O. Date Point of
(/) Transportation
Q by Common Shipment
Carrier Destination
DisintermentDate Cemetery Address
Date Cemetery Address
E Reinterment
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
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 05/25/2022 Registrar of Vital Statistics Shelley Mckernon(ECectronicalry Signed)
(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:
Z � f�
6Date of Disposition S.,zB?O1zPlace of Disposition �A � (���.(�,� Cram�C"�'o r.�
(address)
W
CC (section) (lot num r) (grave number)
8 Name of Sexton or Person in Charge of remissAr�►®"`� 1Wp>d
Z (please p int)
liJ Signature c Title �
DOH-1555(07/18)p 1 of 2 "
#asuaai'1 •23g sJoaaax1Q iu.zaund IT?0330
atuuad pauiu auroq ieiaun3 alp 2uuuasaidag baptuaD nna'A auid
OZ uo paJaniiaP j Jo suieuza.J u1umH
ldtaaag
(gZ)S717 '00S Awl atiand
P1.. `- ry