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Morehouse,Rena Lynn
73 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Rena Lynn Morehouse Female Date of Death Age If Veteran of U.S.Armed Forces, 03/21/2023 68 Years War or Dates F,. Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital a Manner of Death El Natural Cause Accident ❑Homicide ESuicide Undetermined Fl Pending W V Circumstances Investigation © Medical Certifier Name Title "` Shahid Ahmed MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number Cit",Town or Village 5601 156 Burial Date Cemetery,Crematory or Facility Name 03/23/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation goRemoval Date Place Removed — and/or and/or Held N Hold Address 0 O. Date Point of CA ElTransportation p by Common Shipment Carrier Destination IDDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home , 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above 2 Address Q W a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/23/2023 Registrar of Vital Statistics Megan Wolin(E(ectronicalTy 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: Date of Disposition ,..3--0c-20Z3 Place of Disposition r"4 A)P Vie0 e ft.. ai 2 (address) W U) Q (section/ //// � (l nu need (grave number) SName of Sexton or Person in Charge f Premis s �Ar/1�CN'J L�/v0 Z - �f (please print) W Signature Title O et`—'L,4e*r DOH-1555(07/18)p 1 of 2 i Public Health Law Sec. 4145(2b) `r ��`` >a F` Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#