Loading...
Jones, Mette Aude P 7s-61 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Mette Aude Jones Female Date of Death Age If Veteran of U.S.Armed Forces, 09/19/2023 75 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Village Street Address 231 Broadway, Fort Edward Village, New York 12828 Manner of Death g � �Natural Cause Accident Homicide Suicide Undetermined ❑Pendin W Circumstances Investigation U W Medical Certifier Name Title W Day PA Address 79 North Street,Granville Town,New York 12832 Death Certificate Filed Town Of Fort Edward District Number Register Number City,Town or Village 5755 80 Burial. Date Cemetery,Crematory or Facility Name 09/21/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed - and/or and/or Held - Hold Address 0 d Date Point of ( Transportation Shipment p by Common Carrier Destination O Disinterment Date Cemetery Address 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 Remains are Shipped,If Other than Above Address Q W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/21/2023 Registrar of Vital Statistics Aimee G Mahoney(ECectronica(CySigned) (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 I r (13 Place of Disposition4.__ AIL ddress) W N 0 //allot (section/ number/ (grave number) Name of Sexton or Person in Charge of Premises titse print) W Signature Title l/ �� DOH-1555(07/18)p 1 of 2 e { 1 �} Public Health Law Sec. 4145(2b) Receipt ".c ;'y \ i; h Human remains of delivered on__ , 20 r Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# '`'