Harrington, Patricia Lee e k 2 II.
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Patricia Lee Harrington Female
Date of Death Age If Veteran of U.S.Armed Forces,
02/28/2023 70 Years War or Dates
H Place of Death Hospital,Institution or
Z City,Town or Village Albany Street Address Albany Medical Center Hospital
ILI
p Manner of Death ri Natural Cause Accident []Homicide []Suicide []Undetermined []Pending
W I (Circumstances ' 'Investigation
V
W Medical Certifier Name Title
CI Kaitlyn Peper MD
Address
43 New Scotland Ave,Albany,New York 12208
Death Certificate Filed City Of Albany District Number • Register Number
City,Town or Village 0101 0516
R
Burial Date Cemete y,Crematory or Facility Name
03/06/2023 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
0z❑Removal Date Place Removed
and/or and/or Held
H Hold Address
U)
0
d Date Point of
U) Transportation
El Common Shipment
Carrier Destination
[]Disinterment
Date Cemetery Address
[]Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Carleton Funeral Home Inc 00281
Address
68 Main Street,P.O.Box 67,Hudson Falls,New York 12839
Name of Funeral Firm Making Disposition or to Whom
H Remains are Shipped,If Other than Above
5 Address
CC
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 tnanielTe S Gillespie(Electronically Signed)
(signature)
District Number 0101 Place City Of Albany
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ��/
F— L1 .__`
Z Date of Disposition 3 $ Z 3 Place of Disposition „It
W
2 (address)
W
N
Cr /section/ d(lot number/ C (grave number)
ft
0 Name of Sexton or Person in Charge of Premises /'�"° L- ✓ ^'f
z
0 �� /p ase print/
W Signature `S Title 1�
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) 7 -
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#