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Kennedy, Linda Jane • s NEW YORK STATE DEPARTMENT OF HEALTH Y LFJ Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Linda Jane Kennedy Female Date of Death Age If Veteran of U.S.Armed Forces, 08/03/2023 78 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Town Street Address Fort Hudson Nursing Center Inc pManner of Death Natural Cause Accident ❑Homicide Suicide Undetermined El Pending U Circumstances Investigation LU Medical Certifier Name Title Philip Gara MD 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 68 Burial Date Cemetery,Crematory or Facility Name 08/05/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation Z❑Removal Date Place Removed and/or and/or Held F- Hold Address CO 0 a Date Point of U)❑Transportation p by Common Shipment Carrier Destination Disinterment 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 H Remains are Shipped,If Other than Above 5 Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/04/2023 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: II— I Date of Disposition e�-Zoz j Place of Disposition P. ,,)e. yi"e,� e/`� ail r1 2 (address) U)U) 7, (section) (lot nu ber/ f (grave number/ Q � 00c4 O Name of Sexton or Person in Char of Premises,:' �14YrY10a Z � _ i (please print) W Si nature ? ,,I/ ! Title c3-0—ti- t d5S g / DOH-1555(07/18)p 1 of 2 l .,.r ..* (ve ^1 Public Health Law Sec. 4145(2b) 1 t Receipt Human remains of delivered on , 20 • Pine View Cemetery Representing the funeral home named chi bral permit Official Funeral Directors Reg. or License# �`'`