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Fischer, Doreen Pearl
1(LOF NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Doreen Pearl Fischer Female Date of Death Age If Veteran of U.S.Armed Forces, 01/09/2024 63 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ZI Natural Cause Accident Homicide DSuicide pUndetermined El Pending W Circumstances Investigation W Medical Certifier Name Title 0 Christopher Smith 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 19 Burial Date Cemetery,Crematory or Facility Name 01/10/2024 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York jDonation 6❑Removal Date Place Removed H and/or and/or Held N Hold Address 0 O. Date Point of N Transportation p by Common Shipment Carrier Destination IIIDisinterment 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 f.. Remains are Shipped,If Other than Above 2 Address CC W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/10/2024 Registrar of Vital Statistics Megan Not'n(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: IH W Date of Disposition I lib 12y Place of Disposition rr,.v 6.) (address) W CC N (section) (lot number) (grave number) Grg �n`s L tit Name of Sexton or Person in Cha Z (pl se print) W Signature (�a of Premises Title rPrin4i lI� DOH-1555(07/18)p 1 of 2 11_7 S 4 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Rcpresenting the funeral home named on burial permit Official Funeral Directors Reg.or License#