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Bavaro, Catherine R 1.WOO , . _NEW YORK STATE DEPARTMENT OF H EALTH L.@► Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Catherine R.Bavaro Female Date of Death Age If Veteran of U.S.Armed Forces, 12/07/2023 30 Years War or Dates F- Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ❑X Natural Cause Accident Homicide Suicide Undetermined El Pending ILI Circumstances Investigation 0W Medical Certifier Name Title 0 Gamal Khalifa 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 578 Burial Date Cemetery,Crematory or Facility Name 12/12/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held ~ Hold Address N Date Point of 002 Transportation Shipment ES by Common Carrier Destination Disinterment Date Cemetery Address ❑Reinterment 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 }.. Remains are Shipped,If Other than Above S. Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/12/2023 Registrar of Vital Statistics Megan Wolin(ECectronicalry 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: I— W Date of Disposition it(l`k`j) Place of Disposition -rTN Ed fe0 (E S�A'tOf`t 610\ 2 (address) W INLC (section/ (lot limber) (grave number) gName of Sexton or Person in Charge of Premisesa ra1�.- 5�,.it Z (please printiW Signature d" Title I�'c'r+►iT( DOH-1555(07/18)p 1 of 2 ' C 1 7 7S 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#