Manning, Michael Steven .. •NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Michael Steven Manning Male
Date of Death Age If Veteran of U.S.Armed Forces,
07/27/2022 76 Years War or Dates 1965-1967
i_ Place of Death Hospital,Institution or
WCity,Town or Village Albany Street Address Albany Medical Center Hospital
p Manner of Death ❑X Natural Cause Accident ❑Homicide []Suicide []Undetermined Pending
U Circumstances Investigation
W Medical Certifier Name Title
a Lynn Tran NP
Address
43 New Scotland Ave,Albany,New York 12208
Death Certificate Filed City Of Albany District Number Register Number
City,Town or Village 0101 1743
Burial Date Cemetery,Crematory or Facility Name
07/29/2022 Pine View Crematorium
Entombment Address
▪Cremation Queensbury Town,New York
▪Donation
0❑Removal Date Place Removed
and/or and/or Held
t- Hold Address
CO
0
O. Date Point of
(/)[]Transportation Shipment
Q by Common
Carrier Destination
Date Cemetery Address
Disinterment
Reinterment
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
[- Remains are Shipped,If Other than Above
2 Address
Ill
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 07/29/2022 Registrar of Vital Statistics 'Damelte S Cjillespie(ECectronica((ySigned)
(signature)
District Number 0101 Place City Of Albany
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
~ f-1
Z Date of Disposition 7,30-ZvZL Place of Disposition �.^Je (J��� Cr w
W ((address)
W
N°C (section) (lot numbe (grave number)
SName of Sexton or Person in Charge o remiss 74 VOl (please print)
W Signature r Title 0 per
DOH-1555 lo7/18)p 1 of 2
Public Health Law Sec. 4145(2b) 6
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#