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Winchell, Harold Leslie �` - # L/fig NEW YORK STATE DEPARTMENT OF HEALTH I Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Harold Leslie Winchell Male Date of Death Age If Veteran of U.S.Armed Forces, 06/02/2023 84 Years War or Dates 1957-1963 i_ Place of Death Hospital,Institution or Z City,Town or Village Hartford Town Street Address 319 County Route 19, Hartford Town, New York 12827 W Manner of Death ri Undetermined Pending W Natural Cause Accident Homicide nSuicide Circumstances Investigation W Medical Certifier Name Title 0 Courtney Bowers NP Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed Town Of Hartford District Number Register Number City,Town or Village 5759 Burial R Date Cemetery,Crematory or Facility Name 06/06/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ❑Removal Date Place Removed and/or and/or Held F- Hold Address U) 0 O. Date Point of U) Transportation p by Common Shipment Carrier Destination o Disinterment Date Cemetery Address 0 Reinterment 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 1... Remains are Shipped,If Other than Above % Address C W • a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/06/2023 Registrar of Vital Statistics Denise 1'etteysgkctronicaty Signed) (signature) District Number 5759 Place Town Of Hartford I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Z Date of Disposition (011 173 Place of Disposition t,t 2 (address/ W U) CC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises "�' - � 0 ()lase print/ /� Z 1 l 4' t W Signature .� Title l DOH-1555(97/18)p 1 of 2 Public Health Law Sec. 4145(2b) 1 Receipt Human remains of ' delivered on , 20 1 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# t W j �` w