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Gregory, Sylvia Mae -7gg NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Sylvia Mae Gregory Female Date of Death Age If Veteran of U.S.Armed Forces, 10/01/2023 64 Years War or Dates H Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital 0 Manner of Death ❑^ Natural Cause Accident El Homicide []Suicide []Undetermined []Pending UI 'Circumstances I !Investigation W Medical Certifier Name Title G Michael Fuller MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 452 []Burial Date ' Cemetery,Crematory or Facility Name 10/03/2023 Pine View Crematory []Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 O. Date Point of (f)[]Transportation Q by Common Shipment Carrier Destination []Disinterment Date Cemetery Address []Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above N Address CC ILL) O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/02/2023 Registrar of Vital Statistics Megan Nolin(Electronically Signed) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Z Date of Disposition IC!' 43 Place of Disposition 'zJEU;4 J [aa' 1411W P\ W g (address/ W NCC (section) (lot number) (grave number) gfi Es�. i) 1�� cl Name of Sexton 1sonihargemises ease print)Z W bra Signature Title DOH-1555(07/18)p 1 of 2 • k� ``t Public Health Law Sec. 4145(2b) Receipt ' Human remains of •} delivered on , 20 At A Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# _? '