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N EW YORK STATE DEPARTMENT OF H EALTH t 444.
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Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
Carolyn Mae Getty Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/17/2023 89 Years War or Dates
i_ Place of Death Hospital,Institution or
Z City,Town or Village Hebron Town Street Address 898 County Route 31, Hebron Town, New York 12832
WtL Manner of Death Undetermined Pending
1:1Natural Cause Accident Homicide Suicide
U Circumstances Investigation
W Medical Certifier Name Title
CI Carl Beckler MD
Address
278 VT RT. 149,West Pawlet,Vermont 05775
Death Certificate Filed Town Of Hebron District Number Register Number
City,Town or Village 5760 01
Burial Date Cemetery,Crematory or Facility Name
.ir 01/20/2023 Pine View Crematory
Entombment Address
EICremation Queensbury Town,New York
DDonation
0❑Removal Date Place Removed
and/or and/or Held
H Hold Address
N
0
G. Date Point of
(I)0Transportation Shipment
p by Common
Carrier Destination
Ei
Disinterment
Date Cemetery Address
El
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077
Address
123 Main St,Argyle,New York 12809
Name of Funeral Firm Making Disposition or to Whom
F. Remains are Shipped,If Other than Above
5 Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/20/2023 Registrar of Vital Statistics Dorothy Worthington(ECectronica((ySigned)
(signature)
District Number 5760 Place Town Of Hebron
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition lib 17 3 Place of Disposition ',,Ali 7, ram..__
W (address)
W
NCC (section) (lot number) (grave number)
0 Name of Sexton or Person in Charge of Premises / .I l'—'
Z
(p!e se print)
W Signature 7.L.,/,
4'.
Title � 7 �2
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#