Greenwood, James E. Jr. s+°‘
NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Vital Records Burial - Transit Permit
Name First Middle
Last Sex
James E Greenwood Jr
Date of Death Male
Age If Veteran of U.S.Armed Forces,
06/27/2022 75 Years War or Dates
�.. Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls
W Street Address Glens Falls Hospital
Uo Manner of Death CI Natural Cause []Accident []Homicide Suicide
❑Undetermined []Pending
W Medical Certifier Circumstances Investigation
0 Name Title
Asim Chaudry MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number
City,Town or Village 5601 Register Number
340
Burial Date Cemetery,Crematory or Facility Name
06/30/2022 Pineview Crematory
Entombment Address
Cremation Queensbury,New York
Donation
c❑Removal Date Place Removed
1= and/or and/or Held
N Hold Address
0
N'.Transportation Date Point of
p by Common Shipment
Carrier Destination
ElDisinterment Date Cemetery Address
■Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Densmore Funeral Home Inc 00448
Address
7 Sherman Ave,Corinth,New York 12822
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
a Address
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 06/29/2022 Registrar of Vital Statistics Megan Nolin(Electronically Signed)
/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:
WDate of Disposition 3O—ZiZZ Place of Disposition �� .J� if;e �r�7adz,r
J
(address)
ILL!
U)
Q (section) ,,// (lot number) (grave number)
aName of Sexton or Person in Charge of emises �LjJ i,1 . �� �j>i°![��
Z, Charge
(please print/
Signature �= Title QP.etitio(--
DOH-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#