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Dessaint, Margaret Elizabeth NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Margaret Elizabeth Dessaint Female Date of Death Age If Veteran of U.S.Armed Forces, 07/13/2023 94 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Town Street Address 3 Dennis Avenue, Fort Edward Town, New York 12839 W Manner of Death Undetermined Pending � �Natural Cause Accident �Homicide Suicide W Circumstances Investigation U W Medical Certifier Name Title O Anne Evans DO Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed Town Of Fort Edward District Number Register Number City,Town or Village 5755 62 Burial Date Cemetery,Crematory or Facility Name 07/18/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York , `\ Donation o❑Removal Date Place Removed and/or and/or Held N Hold Address 0 G- Date Point of t!) Transportation Shipment p by Common Carrier Destination Date Cemetery Address Disinterment Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/18/2023 Registrar of Vital Statistics Aimee L Mahoney(ECectronicatTy 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: Z Date of Disposition 7111 73 Place of Disposition F (1J (address) W CC N (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises ' lease print) Z IL Signature Title / DOH-1555(07/i8)p 1 of 2 ny a� .w 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#