Graves, Candy Sue NEW YORK STATE DEPARTMENT OF HEALTH ` Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Candy Sue Graves Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/04/2023 64 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Amsterdam Town Street Address Capstone Center For Rehabilitation And Nursing
LU
Manner of Death El Natural Cause []Accident 0 Homicide Suicide Undetermined []Pending
W Circumstances / 'Investigation
W Medical Certifier Name Title
Eyad Aldaas MD
Address
302 Swart Hill Rd,Amsterdam Town,New York 1201C
Death Certificate Filed Town Of Amsterdam District Number Register Number
City,Town or Village 2850 5
Burial Date Cemetery,Crematory or Facility Name
01/06/2023 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
0 Removal Date Place Removed
and/or and/or Held
l Hold Address
0
CL Date Point of
Cl) Transportation
p by Common Shipment
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
1— Remains are Shipped,If Other than Above
55 Address
CC
W
0-
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/06/2023 Registrar of Vital Statistics Linea(Bartone-7-fug/ies(EfectronicalTy Signed)
(signature)
District Number 2850 Place Town Of Amsterdam
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Ir J�
Z Date of Disposition /-7-Z023 Place of Disposition rJQ ✓,e„c.j
W
2 (address)
W
CC
N (section) (lot'limber) (grave number)
0 Name of Sexton or Person in Charge of remises /a 5%)%60t,b ace,[7
Z (please print)
W Signature Title OrP�4'
DOH-1555(07/18)p 1 of 2
ItJ1 :-;, '"72
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#