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Tarn, Gail Susan NEW YO RK STATE DEPARTMENT OF HEALTH j Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Gail Susan Tarn Female Date of Death Age If Veteran of U.S.Armed Forces, 07/08/2023 73 Years War or Dates F. Place of Death Hospital,Institution or W City,Town or Village Hudson Falls Village Street Address 27 Pearl Street 1,Hudson Falls Village, New York 12839 p Manner of Death EI Natural Cause Accident Homicide Suicide Undetermined IT Pending VCircumstances Investigation a Medical Certifier Name Title Autumn Webb PA Address 102 Park Street,Glens Falls,New York 12801 Death Certificate Filed Village Of Hudson Falls District Number Register Number City,Town or Village 5726 19 BurialE Date Cemetery,Crematory or Facility Name 07/11/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York EIDonation g❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 O. Date Point of Cl) Transportation p by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom I— Remains are Shipped,If Other than Above ' Address CC uJ n' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/11/2023 Registrar of Vital Statistics Cynthia Bardin(E(ectronica1Ty Signed) (signature) District Number 5726 Place Village Of Hudson Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H W Date of Disposition I)`l3 Place of Disposition {�,(( 2 (address) W Cr N (section) / (lot number (grave number) gName of Sexton or Person in Charge o Premises nr L at z /please prin W Signature Title V �a6^1r d2 DOH-1555(o7/t8)p 1 of 2 t 1Public Health Law Sec. 4145(2b) Receipt k 1 i ` -r Human remains of 1 delivered on , 20 ' -1 Pine View Cemetery Representing the funeral home named,on 1]grial ppmit Official Funeral Directors Reg.or License# °