Harrington, Bella E North Carolina
Department of Health and Human Services
N.0 Vital Records BURIALTRANSIT Catawba
County
Name of Deceased Date of Death (month, day,year)
Bella E. Harrington 12/30/2023
Place of Death (Name of Institution or Street Address) City County
Frye Regional Medical Center Hickory, NC Catawba
Name and Address of Attending Physician
Dr. Charles Graham ua0 A) Cm 54, 14,cifory , ,uc ;$6o
Destination (Name and Address)
Carleton Funeral Home, 68 Main St, Hudson Falls, NY 12839
Name and Address of Funeral Home
Bass-Smith Funeral Home, 334 2nd Street, NW, Hickory, NC 28601
A Notification of Death having been filed,permission is hereby granted to Date Issued 01/03/2024
remove the body from this state.
Signature of Local Registrar, Deputy Registrar or Address
Sub-Registrar (� 334 2nd Street, NW
��/
/�� a, lV Hickory, NC 28601
IMPORTANT INSTRUCTIONS BACK OF FORM.
DHHS 1184(Revised 042014(Funeral Directors Copy-White
N C Vital Records Local Registrars Copy-Pink
Public Health Law Sec. 4145(2b) �� _ -�-7
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
HARRINGTON
Lot No. 31-C
Address 214 Maple St . Glens Falls NY 12801 ( Section No.
Owner Bella Harrington Plot Seneca
Date 8/13/02
Approx. 33 Superficial ft. @
Location Bounded on North by Woods , South by Vacant , East by Vacant ,
West by Doyle.
Corner Posts
Remarks C • i'1 h l� Q I [ d S r[ S ? d
Deed No. (and changes) 3189
Payment Record Paid in Full 8/13/02 ($400. 00)
Record of Interments
J Robert D. Harrington 8/16/02 (CREM) DN V S
►3ci�ct l R,,c � 1 al 1a (. 5 V
3 0 4 u)
4 )(15
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Form No. 01
HARRINGTON
NAME Bella Harrington �F Age: NA
Lot Owner: Bella Harrington
Lot# Seneca 31 C Grave# 1
Case:
Concrete
Died: 1 2.3 0.2 3 Interred: 1 .27.24
Funeral Home: Carleton FH
Cemetery: Pine View