Parrott, Sherman Emrys # S35
,
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of VitaL Records
Name First Middle Last Sex
Sherman Emrys Parrott Male
Date of Death Age If Veteran of U.S.Armed Forces,
07/04/2022 84 Years War or Dates 1956-1960
P Place of Death
Hospital,Institution or
Z
City,Town or Village Glens Falls Street Address Glens Falls Hospital
p Manner of Death n Natural Cause Accident n Homicide Suicide nUndetermined Pending
W Circumstances Investigation
W Medical Certifier Name Title
p Shahid Ahmed 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 354
R
Burial Date Cemetery,Crematory or Facility Name
07/06/2022 Pine View Crematorium
Entombment -Address
Cremation Queensbury Town,New York
riDonation
OZ❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
G. Date Point of
Cl)❑Transportation Shipment
Q by Common
Carrier Destination
nDisinterment
Date Cemetery Address
nReinterment 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
5 Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 07/06/2022 Registrar of Vital Statistics T'tegan Wain(E(ectronica1TySigned)
(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:
W Date of Disposition I ZZ Place of Disposition Pk.e.
�i --�
2 (address)
W
O (section) (lot
t number) (grave number)
p Name of Sexton or Person in Charge o Premises L
(prase prin
W Signature iE� Title ` ��"C
D0 H-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#