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Hall, Dawn Loudon Prindall
:F 0) NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Dawn Loudon Prindall Hall Female Date of Death Age If Veteran of U.S.Armed Forces, 11/01/2023 66 Years War or Dates J.- Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital Q Manner of Death El Natural Cause EAccident El Homicide Suicide ❑Undetermined 17 Pending W 0 Circumstances Investigation QW Medical Certifier Name Title Shahid Ahmed MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number Cit ,Town or VillageE 5601 511 Burial Date 11/03/2023 Cemetery,Crematory or Facility Name Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation Removal Date Place Removed c and/or and/or Held N Hold Address 0 G. Date Point of Cl) Transportation S by Common Shipment Carrier Destination Disinterment Date Cemetery Address EiReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1.- Remains are Shipped,If Other than Above 2 Address R 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 Wolin(ECectronicattySigned) (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: I— W Date of Disposition //l� j23 Place of Disposition ?�J e f e,,J ('r—e p1A.� 2 (address) W W Q 7:1 (section) (lot nu,ber) (grave number) gName of Sexton or Person in Charge rem' es, i<lol i./"r✓ (,t/O(�/ Z I (please print) W Signatures Title (7�'�k r DOH-1555(07/18)p 1 of 2 ` s 0 1 r� 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#