McGee, Martha Cecilia NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Martha Cecilia McGee Female
Date of Death Age If Veteran of U.S.Armed Forces,
08/20/2022 75 Years War or Dates
t` Place of Death Hospital,Institution or
Z City,Town or Village Hartford Town Street Address 31 Miller Ridge Way, Hartford Town, New York 12838
W Manner of Death ❑ ❑ ❑ Undetermined �Pendin
0 X Natural Cause Accident Homicide Suicide g
W Circumstances Investigation
W Medical Certifier Name Title
CI William Parker MD
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed Town Of Hartford District Number Register Number
City,Town or Village 5759 10
RBurial Date Cemetery,Crematory or Facility Name
08/29/2022 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
ZO❑Removal Date Place Removed
and/or and/or Held
H Hold Address
N
0
O. Date Point of
U) Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
ElReinterment 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
N Address
Q
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/24/2022 Registrar of Vital Statistics Denise Tetteys(Electronically Signed)
(signature)
District Number 5759 Place Town Of Hartford
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W~ 4____
Date of Disposition $ jy Ili_ Place of Disposition
2 (ad ess/
W
U)
CC (section) (lot number) {� (grave number)
,P r
S Name of Sexton or Person in Charge of Pre s ti '�""'f'V
Z (plc se print)
W Signature - Title C ilTti
DOH-1555(07/18)p 1 of 2
1161 9 %
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
't ie View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg. or License#