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Tooker, Claire Marie , 0 ft 137 NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Claire Marie Tooker Female Date of Death Age If Veteran of U.S.Armed Forces, 02/06/2023 79 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare p Manner of Death ❑� Natural Cause Accident ❑Homicide OSuicide nUndetermined ❑Pending W U I (Circumstances Investigation W Medical Certifier Name Title CI Sandita Seecharan MD Address 4573 State Route 40,Argyle Town,New York 12809 Death Certificate Filed Town Of Argyle District Number Register Number City,Town or Village 5750 7 HBurial Date Cemetery,Crematory or Facility Name 02/08/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 d Date Point of U)DTransportation p by Common Shipment Carrier Destination nDisinterment Date Cemetery Address Date Cemetery Address Ill Reinterment 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 1— Remains are Shipped,If Other than Above g Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/08/2023 Registrar of Vital Statistics Shelkey Mt-karma(EkctronicalySigned) (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— /, 7�e ✓�Z Date of Disposition 2,.�-zjz� Place of Disposition t, r„, ci.,c417 2 (address) W NCC (section) (lot nu (grave number) 0 Name of Sexton or Person in Charge remiss ������ ''�''"l7 e print/ IIISignature Title eytar DOH-355(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#