Donohue, Margaret Ellen CNEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Margaret ENen Donohue Female
Date of Death Age If Veteran of U.S.Armed Forces,
05/26/2022 88 Years War or Dates
1„. Place of Death Hospital,Institution or
Z City,Town or Village Moreau Town Street Address 14 Merritt Road,Moreau Town,New York 12803
�+ Mannerof Death EINaturalCause ❑Accident Homicide ❑Suicide Undetermined ❑Pending
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C.) Circumstances Investigation
GMedical Certifier Name Title
Lynn Keil PA
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed Town of Moreau District Number Register Number
Cit E,Town or Village 4562 28
Burial Date Cemetery,Crematory or Facility Name
05/31/2022 Pine View Crematory
Entombment Address
JCremation Queensbury Town,New York
Donation
Removal Date Place Removed
F and/or and/or Held
N Hold Address
0
a Date Point of
Cl)ElTransportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Date Cemetery Address
pReinterment
Permit Issued to Registration Number
Name of Funeral Home Regan&Denny Funeral Service 01444
Address
94 Saratoga Ave,S Glens FaNs,New York 12803
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
'a Address
Q
W
a. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 05/29/2022 Registrar of Vital Statistics Lseann Ate cage rEYatawri Signed)
(signature)
District Number 4562 Place Town Of Moreau
I certify that the remains of the decedent identified above were disposed of in accordance with this penniton:
W Date of Disposition E I31 12z `w
Place of Disposition ry 4(L.. te a '
2 (address)
W
CC N (section) (Iot number) (gra►e number)
4 L. .E.-• hiir
g Name of Sexton or Person in Charge of Pre ' (4 �
Z 2/7
� /p!e e print/ /WSignature Title (�R �
DOH 1555(07/18)p 1 of 2
w D �.1
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#