Loading...
Moss, John P. Jr. el elZ NEW YORKSTATE DEPARTMENT OF HEALTH - Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex John P Moss Jr Male Date of Death Age If Veteran of U.S.Armed Forces, 10/31/2023 77 Years War or Dates Korean Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death Undetermined Pending W Natural Cause IllAccident Homicide Suicide Circumstances Investigation WMedical Certifier Name Title G Asim Chaudry MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 510 Burial Date Cemetery,Crematory or Facility Name 11/03/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,Warren, New York Donation ZO❑Removal Date Place Removed and/or and/or Held N Hold Address O a Date Point of U)❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Date Cemetery Address Reinterment Permit Issued to Registration Number Name of Funeral Home Miller Funeral Home 01199 Address 6357 Nys Rte#30, Indian Lake,New York 12842 Name of Funeral Firm Making Disposition or to Whom ▪ Remains are Shipped,If Other than Above 2 Address CC W a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/02/2023 Registrar of Vital Statistics Megan Nolin(Electronically Signed) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: IH Z Date of Disposition //-/-ZpZ,3 Place of Disposition e t.l e v/,'e.0 ( -ei.ithy 11 2 /address) W N (section) lot nu ter) (grave number) elName of Sexton or Person in Cha f Pre ise t )py/yX��� � ��c Z (please print) W Signature /i Title 0e1.-5-4,'-kr DOH-1555(07/18)p t of 2 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#