Connery, Bonnie Sue -A giog
. , ,,(.11.F.)
NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Bonnie Sue Connery Female
Date of Death Age If Veteran of U.S.Armed Forces,
10/29/2023 75 Years War or Dates
i_ Place of Death Hospital,Institution or
Z City,Town or Village Albany Street Address Albany Medical Center Hospital
III
p Manner of Death El Natural Cause Accident n Homicide ESuicide Undetermined ❑Pending
W Circumstances Investigation
W Medical Certifier Name Title
G Gavril Rosoklija
Address
43 New Scotland Ave,Albany,New York 12208
Death Certificate Filed City Of Albany District Number Register Number
City,Town or Village 0101 2555
RDateBurial
Cemetery,Crematory or Facility Name
10/31/2023 Pine View Crematory
Entombment Address
nCremation Queensbury Town,New York
Donation
Z Removal Date Place Removed
❑and/or and/or Held
F Hold Address
N
0
d. Date Point of
Cl)❑Transportation
p by Common Shipment
Carrier Destination
nDisinterment
Date Cemetery Address
Date Cemetery Address
F—Reinterment
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
1— Remains are Shipped,If Other than Above
Address
2
W
C" Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/30/2023 Registrar of Vital Statistics Kerry bartIothmew(ElectronicallSigned)
(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 Jo 131 I/3 Place of Disposition er tJ ti ( ,1Y14(0-9.....,
LLI (address)
W
Cl)CC (section) (lot number) (grave number)
0 Name of Sexton or Person in Charge of P emises d (PIeas
e pant 114
Z / /"
W Signature Title /pim tat
DOH-1555(07/18)p id 2
01 618
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#