Durkee, Diana Kathleen • - i '
NEW YORK STATE DEPARTMENT OF H EALTH �` /f
Bureau of Vital Records `�/ Burial - Transit Permit
Name First Middle Last Sex
Diana Kathleen Durkee Female
Date of Death Age If Veteran of US.Armed Forces,
12/28/2022 59 Years War or Dates
F Place of Death Hospital,Institution or
WCity,Town or Village Queensbury Town Street Address Glens Falls Center for Rehabilitation and Nursing
0 Manner of Death ❑X Natural Cause Accident El Homicide Suicide ❑Undetermined Pending
111
U Circumstances Investigation
aIIJ Medical Certifier Name Title
Jennifer Donovan D'
Address
152 Sherman Ave,Queensbury Town,New York 12801
DeaRth Certificate Filed Town Of Queensbury District Number Register Number
City,Town or Village 5657 194
Burial Date Cemetery,Crematory or Facility Name
12/30/2022 Pine View Crematory
Entombment Address
▪Cremation Queensbury,New York
▪Donation
oZ El Removal Date Place Removed
and/or and/or Held
pHold Address
Transportation Date Point of
IS by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
}- Remains are Shipped,If Other than Above
2 Address
IC
W
O.
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/30/2022 Registrar of Vital Statistics Caroline x((egarr(eBar6er(ECectronica((ySigned)
(signature)
District Number 5657 Place Town Of Queensbury
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition /2-3P-jaz . Place of Disposition tF jje /eta.) Creirketa 1-1-(
lu
2 (address) J
IW
W (section) J ,/ (lot number) (grave number)
Name of Sexton or Person in Charge o remises '9� )Koh,k l%G ci
Z 1�� (please- print)
W Signature Title ceer(�`1�
DOH-1555(07/18)p 1 of 2
• 3 1_65 4 6
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
Pine View Cemetery 1 Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#