Loading...
Underwood, George Hugh f LWF # --).(.3 NEWYORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex George Hugh Underwood Male Date of Death Age If Veteran of U.S.Armed Forces, 09/26/2023 65 Years War or Dates i_ Place of Death Hospital,Institution or W City,Town or Village Argyle Town Street Address 228 West Road,Argyle Town, New York 12809 p• Manner of Death Z Natural Cause EAccident Homicide Suicide Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title O William Parker MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Argyle District Number Register Number City,Town or Village 5750 45 ElBurial Date Cemetery,Crematory or Facility Name 10/02/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0• Removal Date Place Removed and/or and/or Held F- Hold Address N O _.,., C- Date Point of Cl)❑Transportation p by Common Shipment Carrier Destination ODisinterment Date Cemetery Address OReinterment 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 5 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/28/2023 Registrar of Vital Statistics Shelley 9Kckernon(Electronically Signed) (signature) District Number 5750 Place Town Of Argyle I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: II— I Date of Disposition /0131Th Place of Disposition ' .lwevp 4d Ca{/�.:1-nieLvi_ 2 (address) W NCC (section) , (lot number) (grave number) O Name of Sexton or Person in Charge of Premise r,' � N Z please pnn W Signature . _ _ Title l ►i et DOH-1555(07/18)p 1 of 2 .) 1 i'M 31„ 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#