Loading...
Hintz, Ronald Ellisworth NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Ronald Ellsworth Hintz Male Date of Death Age If Veteran of U.S.Armed Forces, 12/14/2023 87 Years War or Dates 1,,, Place of Death Hospital,Institution or W City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare p Manner of Death n Natural Cause nAccident Homicide Suicide nUndetermined El Pending W I I 1Circumstances Investigation W Medical Certifier Name Title G Nicole Humiston NP Address 4573 State Route 40,Argyle Town,New York 12809 Death Certificate Filed Town Of Argyle District Number Register Number City,Town or Village 5750 61 ▪Burial Date Cemetery,Crematory or Facility Name 12/15/2023 Pine View Crematorium Entombment Address ©Cremation Oueensbury Town,New York ▪Donation ZO n Removal Date Place Removed and/or and/or Held N Hold Address 0 O. Date Point of N)nTransportation Shipment p by Common Carrier Destination El Disinterment Date Cemetery Address n 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 Remains are Shipped,If Other than Above a Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/15/2023 Registrar of Vital Statistics Shelley Mckernon(E(ectronica((ySigned) (signature) District Number 5750 Place Town Of Argyle I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition gZ1lf It? Place of Disposition .ritiC✓T 6 m4"(/e"L0—.... ,2 (address) CD (section) of number/ (grave number) 0 Name of Sexton or Person in Charge of pmiser i L— v"`�* z / (please rint) IL Signature /C Title �F m��z 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#