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Albanese, Minnie 4 l 03 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Female Minnie Albanese Date of Death Age If Veteran of U.S.Armed Forces, 03/02/2023 90 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Queensbury Town Street Address Glens Falls Center for Rehabilitation and Nursing W W Manner of Death Undetermined Pending Z Natural Cause Accident 0 Homicide Suicide Circumstances Investigation W Medical Certifier Name Title G Jennifer Donovan DO Address 152 Sherman Ave,Queensbury Town,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 32 Burial Date Cemetery,Crematory or Facility Name 03/02/2023 Pine View Crematory Entombment Address ©Cremation Queensbury.Town,New York Donation z Removal Date Place Removed - and/or and/or Held F—- Hold Address N 2 Date Point of GO Transportation Shipment Q by Common Carrier Destination Date Cemetery Address Disinterment Date Cemetery Address Reinterment Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom ii- Remains are Shipped,If Other than Above r Address tC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/02/2023 Registrar of Vital Statistics Caroline Hildegarde Barber(Electronically Signed) (signature) District Number 5657 Place Town Of Queensbury I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 3I.3123 Place of Disposition `� L-" 41617---- LI! (address) W number) Q (section) (lot number) (grave 4 s1liC L.-- SV.A rt Name of Sexton or Person in Charge of mises z:/•-• (p seprint) Z rr�Y W Signature Title DOH-1555(07/18)p 1 of 2 r 7 r 9 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#