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Beecher, Florence Marie Iii(.6 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Florence Marie Beecher Female Date of Death Age If Veteran of U.S.Armed Forces, 03/21/2023 82 Years War or Dates F Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital WW Undetermined Pending Manner of Death Natural Cause nAccident Homicide Suicide ✓ Circumstances Investigation W Medical Certifier Name Title CI William Cleaver MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 153 Burial Date Cemetery,Crematory or Facility Name 03/23/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation 6 Removal Date Place Removed and/or and/or Held ~ Hold Address 0 O. Date Point of (/)❑Transportation Shipment p by Common Carrier Destination El Disinterment Date Cemetery Address n Reinterment Date Cemetery Address 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 N Remains are Shipped,If Other than Above 2 Address . Q W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/23/2023 Registrar of Vital Statistics Megan Nolin(Electronically Signed) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 317ti 113 Place of Disposition -r„,c ,..- .-1 2 (address) W NCC (section) 4 (lot number) (grave number) sc, 8 Name of Sexton or Person in Charge of Premi Irt tease print/ LLJ Signature Title 11Z /izx� DOH-1555(07/18)p 1 of 2 A r:i ;,`7 Public Health Law Sec. 4145(2b) Receipt Human remains of >. delivered on , 20 Pine View Cemetery Representing the funeral home named on burial pe Official Funeral Directors Reg.or License#