Dudas, Debra Ann ')
. So
NEW YORK STATE DEPARTMENT OF HEALTH
1.--F)
Bureau of Vital Records Burial Transit Permit
Name First Middle Last Sex
Debra Ann Dudas Female
Date of Death Age If Veteran of U.S.Armed Forces,
06/24/2022 63 Years War or Dates
H Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address Glens Falls Hospital
111
p Manner of Death ❑X Natural Cause Accident Ei Homicide 0Suicide Undetermined 17 Pending
LU U Circumstances Investigation
QW Medical Certifier Name Title
Marcille Labban MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 331
Burial Date Cemetery,Crematory or Facility Name
06/27/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
goRemoval Date Place Removed
H and/or and/or Held
N Hold Address
0
O. Date Point of
U):Transportation
p by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan&Denny Funeral Service 01444
Address
94 Saratoga Ave,S Glens Falls,New York 12803
Name of Funeral Firm Making Disposition or to Whom
H Remains are Shipped,If Other than Above
2 Address
CC
W
Q. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 06/27/2022 Registrar of Vital Statistics 9KeganWolin(ECectronica1TySigned)
(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:
IH
W Date of Disposition 61n I z2 Place of Disposition , tL Zit0—......:
2 (address)
uJ
CC U) (section) /j j/ot number) (grave number)
GName of Sexton or Person in Charge of Pre t
Z 116....
ease print)
ILJ Signature Title vvv /` N��
DOH-1555(07/18)p 1 of 2
1
Public Health Law Sec. 4145(2b)
1 Receipt
i
1 Human remains of -- • > delivered on , 20
1
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#—