Sleight, Norma C ti
NEW YORK STATE DEPARTMENT OF HEALTH ' Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Norma C.Sleight Female
Date of Death Age If Veteran of U.S.Armed Forces,
12/06/2022 85 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare
p Manner of Death ❑X Natural Cause nAccident El Homicide Suicide Undetermined Pending
w Circumstances Investigation
W Medical Certifier Name Title
CI Leah Terry NP
Address
4573 4573 NY-40,Argyle Town,New York 12809
Death Certificate Filed Town Of Argyle District Number Register Number
City,Town or Village 5750 63
nBurial Date Cemetery,Crematory or Facility Name
12/09/2022 Pine View Cemetery
IllEntombment Address
Cremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
H Hold Address
0
G. Date Point of
Cl) Transportation
p by Common Shipment
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
L Address
CC
w
n' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/06/2022 Registrar of Vital Statistics Shelley fMckernon(Electronically 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:
I— ,�
W Date of Disposition t� 9• as Place of Disposition 0) (�)uc \ � Q-. "O u 7S %) N� to .4
(address)
w
CC Q (section/ (lot number) (grave number)
aName of Sexton or Person in Charge of Premises vnn C —i UCC�eQ
Z (please print)
w Signature Title Su pc.? 1 rl-tr-ricki)
DOH-1555(07/18)p i of 2
Public Health Law Sec. 4145(2b)
91_2958
Receipt
Human remains of /, ,,r 0,,v , ;` ,, delivered on , 20
1/"
7
' e View Cemetery Repfesenting the funeral home named on burial
cial Funeral Directors Reg.or License# / <- `''
SLEIGHT
NAME NORMA SLEIGHT a LIF Age: $5
Lot Owner: Norma Sleight
Lot# Huron 9F Grave# 1
Case: Concrete
Died: 1 2.6.2 2 Interred: 12.9.2 2
Funeral Home: Carleton FH
Cemetery: Pine View