Lemery-Bigelow, Lorraine i
F ft91
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit'
Bureau of Vital Records
Name First Middle Last Sex
Lorraine Lemery-Bigelow Female
Date of Death Age If Veteran of U.S.Armed Forces,
11/19/2022 97 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Argyle Town Street Address Washington Center ForRehabilitation And Healthcare
• Manner of Death El Natural Cause Accident El Homicide ESuicide Undetermined El Pending
W Circumstances Investigation
W Medical Certifier Name Title
0 Brandii Baker NP
Address
4573 State Route 40,Argyle Town,New York 12809
Death Certificate Filed Town Of Argyle stricter Register Number
City,Town or Village 0 60
Burial Date Cemetery,Crem ory or Facility Name
11/22/2022 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
DDonation
❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
d Date Point of
to ETransportation Shipment
p by Common —
Carrier Destination
Disinterment Date Cemetery Address
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
f. Remains are Shipped,If Other than Above
Address
Q
W
a. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/22/2022 Registrar of Vital Statistics Sfielrey Mckernon(ECectronicaffy signed)
(signature)
District Number 5750 Place Town Of Argyle
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition I i I t3j I Z Place of Disposition
2 (address)
W _
Q (section) lot number) (grave number)
gName of Sexton or Person in Charge of Premises
(pie e print)
Z �)
W Title awinoti7e
Signature
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#