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Russell, Joan Carol NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Joan Carol Russell Female Date of Death Age If Veteran of U.S.Armed Forces, 12/20/2022 84 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital 'p Manner of Death El Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title Charles Ogagan MD Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 2974 ©Burial Date Cemetery,Crematory or Facility Name 12/27/2022 Pine View Cemetery Entombment Address Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held A Hold Address 0 IL Date Point of (0)❑Transportation Shipment p by Common 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 CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/21/2022 Registrar of Vital Statistics cDanielTe S Gifespie(Electronically Signed) (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: Date of Disposition i a-a l pla Place of Disposition Ci\ UD Rc:2,b (address) W �AC t1 1 N (section (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises a(-)n L7 Uc"<Jc-- T Z (please print) W Si nature Title C J 2 1��1( g d DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 012961 Receipt Human remains of — delivered on -/ , 20 4.7- / Mile View Cemetery Representing the funeral home named on burial permit a'Official Funeral Directors Reg.or License# Russell NAME Joan Carol Russell Age: 84 Lot Owner: Charles P. Tisinger Lot# Hudson #1 32A Grave# 3 Case: Concrete Died: 1 2.2 0.2 2 Interred: 12.2 7.2 Funeral Home: Regan Denny Stafford Cemetery: Pine View Tisinger LICIF) Lot No. 32 A Address 52 Mountain View Lane. Glens Falls, N.Y. 12801 Section No. 1 Owner Charles P. Tisinger Plot Hudson Date 7/11/85 Approx. 100 Superficial ft. @ Location Bounded North by Woods, South by Vacant, East by Vacant, West by Vacant Corner Posts Remarks Deed No. (and changes) 1941 Payment Record Paid in Full 7/11/85 Record of Interments I ric)ocil ---1 2 Beatrice A . Tisinger 4/7/99 Al_ 3 .DC2trl S5c_L\ I "ate D "Y1� �01.a).00 4 I V V _ , a x E 5 C G 6I c x a_ 5 7I T Ij s l 1 2 1/uca „ T Form No. 01