Hamilton. Edard Walker I s b
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Edward Walker Hamilton Male
Date of Death Age If Veteran of U.S.Armed Forces,
02/11/2023 82 Years War or Dates 1961-1965
Place of Death Hospital,Institution or
Z City,Town or Village Argyle Town Street Address 460 North Street Road,Argyle Town, New York 12809
WW Manner of Death Undetermined Pending
[]Natural Cause Accident Homicide Suicide []
C.) Circumstances Investigation
W Medical Certifier Name Title
CI Darci Gaiotti-Grubbs MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed Town Of Argyle District Number Register Number
City,Town or Village 5750 8
Burial Date Cemetery,Crematory or Facility Name
02/14/2023 Pine View Crematory
Entombment Address
[]Cremation Queensbury Town,New York
Donation
OZ❑Removal Date Place Removed
and/or and/or Held
t Hold Address
O
4. Date Point of
U)[]Transportation
a. by Common Shipment
Carrier Destination
Date Cemetery Address
[]Disinterment
Date Cemetery Address
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
�.- Remains are Shipped,If Other than Above
-g Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/14/2023 Registrar of Vital Statistics Shelley Mckernon(Electronically Signed)
(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:
Z Date of Disposition 215-etz3 Place of Disposition ,,1e7 t e ereil-nits r
LLJ
2 (address)
W
CCCC (section) (!t numb r/ (grave number)
Name of Sexton or Person in Charg f Pre 's K'�►Ym/4'� OpCi
Z `. (p—lease print)
tL Signature Title Q�PJ�'�_
DOH-1555(o7/18)p t of 2
Public Health Law Sec. 4145(2b) t ��,i;
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#