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Carter, Kenneth H
113 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Kenneth H Carter Male Date of Death Age If Veteran of U.S.Armed Forces, 05/21/2023 81 Years War or Dates F— Place of Death Hospital,Institution or W City,Town or Village Albany Street Address Hudson Park Rehabilitation And Nursing Center Ill Manner of Death Z Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title CI Nosa Aigbe Lebarty MD Address 325 Northern Blvd,Albany,New York 12204 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 1225 Burial Date Cemetery,Crematory or Facility Name 05/24/2023 Pineview Crematory Entombment _ Address ©Cremation Queensbury Town,New York iiiDonation 6❑Removal Date Place Removed and/or and/or Held H Hold Address N fA❑Transportation Date Point of Q by Common Shipment Carrier Destination Disinterment Date Cemetery Address Date Cemetery Address Reinterment Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address Q W 0- Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/23/2023 Registrar of Vital Statistics Danielle 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: II— I Date of Disposition 5-12 s 113 Place of Disposition e`f ,4(/� et 2 (address/ W NCC (section) /f (lot number) (grave number) O Name of Sexton or Person in Charge of Premises a' 1'— 4 ff 0-lase print/ W Signature �;-/l Title �2S+M�}7�'C DOH-1555(07/18)p 1 of 2 I 1Public Health Law Sec. 4145(2b) 1 Receipt 1 Human remains of delivered on - , 20 .. Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#