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Daly, Patricia ..-('''' 7111-. I) # zo NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Patricia Daly Female Date of Death Age If Veteran of U.S.Armed Forces, 03/02/2023 91 Years War or Dates l.- Place of Death Hospital,Institution or W City,Town or Village Scotia Village Street Address Baptist Health Nursing And Rehabilitation Center,Inc p Manner of Death El Natural Cause lilAccident ❑Homicide El Suicide Undetermined ❑Pending W C..) Circumstances Investigation W Medical Certifier Name Title 0 Alexandra Meehan NP Address 297 N Ballston Ave,Scotia Village,New York 12302 Death Certificate Filed Village Of Scotia District Number Register Number City,Town or Village 4620 028 Burial Date Cemetery,Crematory or Facility Name 03/06/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York DDonation ZO❑Removal Date Place Removed and/or and/or Held F- N Hold Address 0 Date Point of (I)❑Transportation Shipment p by Common Carrier Destination Date Cemetery Address Disinterment EDReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom i- Remains are Shipped,If Other than Above 5" Address CC W 0 Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/06/2023 Registrar of Vital Statistics Maria/InnScltmitz(E/ctronicaf Stgner) (signature) District Number 4620 Place Village Of Scotia I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Date /) W Date of Disposition 31 lc i Z3 Place of Disposition �M ! (address) W CC (section) (!ot number/S (grave number) a Name of Sexton or Person in Charge of P emises /I�„ La l It Q (please print) z /� % cw�Q IL Signature Title DOH-1555(07/18)p 1 of 2 6 77 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#