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Harrington, Audrey Ann .,5) It -7te NEW YORK STATE DEPARTMENT OF HEALTH / Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Audrey Ann Harrington Female Date of Death Age If Veteran of U.S.Armed Forces, 03/26/2023 k 86 Years War or Dates I - Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Town Street Address Fort Hudson Nursing Center Inc Ww Manner of Death Undetermined Pending IZINatural Cause Accident Homicide Suicide U Circumstances Investigation W Medical Certifier .luame Title O Carrie Miron PA Address 319 Broadway, Fort Edward Town, New York 12828 Death Certificate Filed Town Of Fort Edward District Number Register Number City,Town or Village 5755 34 Burial Dates Cemetery,Crematory or Facility Name IMMO 03/2812023 Pine View Crematory _Entombment - Add�ie s., ©Cremation Queensbury Town,New York Donation ` ZZ 1-1 Removal Date Place Removed and/or and/or Held H Hold Address N 0 a Date Point of Cl)❑Transportation p by Common Shipment Carrier Destination E Disinterment Date Cemetery Address OReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 Address 123 Main St,Argyle,New York 12809 Name of Funeral Firm Making Disposition or to Whom F— Remains are Shipped,If Other than Above 2 Address OC W 0- Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/27/2023 Registrar of Vital Statistics Aimee G Mahoney(ECectronicaCCy Signed) (signature) District Number 5755 Place Town Of Fort Edward I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Z Date of Disposition 3INIt3 Place of Disposition FM <, .._ 2 (address) W N (section) �j' (lot number) ._-_ (grave number) o� ////i(% �`Gin,• Name of Sexton or Person in Charge of Premises ^��-' I+ Z g C (please print) l W Signature Title l Q`"� DOH-1555(07/18)p 1 of 2 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#