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Morgan, Elizabeth Ann NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Elizabeth Ann Morgan Female Date of Death Age If Veteran of U.S.Armed Forces, 11/15/2023 76 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Moreau Town Street Address 236 Ferry Boulevard,Moreau Town,New York 12803 in Manner of Death Undetermined Pending Natural Cause Accident Homicide Suicide n g Circumstances Investigation W Medical Certifier Name Title O William Parker MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Moreau District Number Register Number City,Town or Village 4562 65 Burial Date Cemetery,Crematory or Facility Name 11/17/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York DDonation Removal Date Place Removed and/or and/or Held H Hold Address 0 CI. Date Point of U) Transportation by Common Shipment Carrier Destination ODisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above Address CC W Q. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/17/2023 Registrar of Vital Statistics Brenda.7futter(E(ectronica((ySigned) (signature) District Number 4562 Place Town Of Moreau I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: l— Z Date of Disposition +(1 it 1 Z3 Place of Disposition ''JN�r C e wrie,tv.,... 111 2 (address) W CC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Prem. s f 4- Z ( ease print) f W Signature Title ` 'q Pi( DOH-1555(07/18)p 1 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#