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Tennyson, Sharon Lee limEt i . It 1024 NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Sharon Lee Tennyson Female Date of Death Age If Veteran of U.S.Armed Forces, 12/14/2023 75 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death El Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title a Matthew Loftus PA 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 595 Burial Date Cemetery,Crematory or Facility Name 12/19/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation ORemoval Date Place Removed and/or and/or Held 0 Hold Address 0 CL Date Point of (/)ETransportation p by Common Shipment Carrier Destination Disinterment El Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom i- Remains are Shipped,If Other than Above Address CIC C" Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/19/2023 Registrar of Vital Statistics Megan No(in(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: I- W' Date of Disposition i2 t170(73 Place of Disposition rTJ 't i j Goi.4V A Iva-Wu, 2 (address) W NCC (section) /J (lot number) (grave number) ci Name of Sexton or Person in Charge of Premises ''' „...q AA' Z67 - ) (please print) /" lJV Signature i� Title `W.'Th't DOH-1555(07/18)p 1 of 2 1 7 7 7 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#