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Raymond, Elizabeth Florence i ' (1.70,, NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Elizabeth Florence Raymond Female Date of Death Age If Veteran of U.S.Armed Forces, 09/27/2023 80 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address St Peters Hospital W p Manner of Death Natural Cause []Accident []Homicide []Suicide Undetermined []Pending [] W I C.) Circumstances I 'Investigation QMedical Certifier Name Title Sulaiman Hasan MD Address 315 S Manning Blvd,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 2260 Burial Date Cemetery,Crematory or Facility Name 09/28/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation Z Date Place Removed 0Z❑Removal and/or Held If— and/or N Hold Address 0 a Date Point of CO)[]Transportation a- by Common . Shipment Carrier Destination ElDisinterment Date Cemetery Address EI 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 1— Remains are Shipped,If Other than Above Address CC n' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/28/2023 Registrar of Vital Statistics Kerry(Bartholomew(EYectronica((y Signed) (signature) District Number 0101 Place City Of Albany I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Z Date of Disposition I I2`I 123 Place of Disposition Ff:re i; .-.) (R-6.41471 Pt'JI ILI 2 (address) W Q (section) J (lot nu . (grave number) L 0 Name of Sexton or Person in Charge of Premises r, (please r +ff ZP W Signature C Title I -YI►1' DOH-1555(07/18)p 1 of 2 �_ .y e , Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on butial permit Official Funeral Directors Reg.or License#