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Bourdeau, Alcide Thomas # s,,, ...., 6 NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Alcide Thomas Bourdeau Male Date of Death Age If Veteran of U.S.Armed Forces, 10/18/2023 77 Years War or Dates 1971-1971 p Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital Ill p Manner of Death Natural Cause Accident Homicide Suicide Undetermined ❑Pending W ' J Circumstances Investigation U W Medical Certifier Name Title CI Travis Wheeler DO Address 43 New Scotland Ave,Albany,New York 12208 DeaEth Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 2473 Burial Date Cemetery,Crematory or Facility Name 10/20/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York lilDonation Date Place Removed ❑Removal and/or Held F- and/or N Hold Address 0 Date Point of U) Transportation Shipment Q by Common Carrier Destination El Disinterment Date Cemetery Address Date Cemetery Address El Reinterment 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 1— Remains are Shipped,If Other than Above N Address CC W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/19/2023 Registrar of Vital Statistics ?(ety Bartholomew(Electronica1T Signee (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 /�-�/�-zo 3 Place of Disposition T' I - Virg 1 Cre, i do f• j W (address) W Cl)CC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge Premi �►47 m0^3 yfJ C Z I (please print) W Signature Title 0e�'L'4`f" DOH-1555(07/i8)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of ��'� 1 1 . . .t delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# j u; { 7