Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Sexton, Cheryl June
# S, . *(1.7/0,10 NEW YORKSTATE DEPARTMENT OF HEALTH Burial- Transit Permit Bureau of Vital Records Name First Middle Last Sex Cheryl June Sexton Female Date of Death Age If Veteran of U.S.Armed Forces, 01/13/2024 73 Years War or Dates i_ Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Town Street Address Fort Hudson Nursing Center Inc 111 0 Manner of Death ❑X Natural Cause Accident ❑Homicide Suicide Undetermined Pending II3I—ICircumstances Investigation U Q Medical Certifier Name Title Elizabeth Bessette NP Address 319 Broadway,Fort Edward Town,New York 12828 Death Certificate Filed Town Of Fort Edward District Number Register Number City,Town or Village 5755 3 EdBurial Date Cemetery,Crematory or Facility Name 01/16/2024 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York ▪Donation goRemoval Date Place Removed IL- and/or and/or Held (7,) Hold Address 0 d Date Point of (I) Transportation p by Common Shipment Carrier Destination EiDisinterment Date Cemetery Address 111 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 ii- Remains are Shipped,If Other than Above a Address CC uJ 0 Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/16/2024 Registrar of Vital Statistics Aimee L Mahoney(E(ectronica1Ty Signed) (signature) District Number 5755 Place Town Of Fort Edward I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Z Date of Disposition I 1110121 Place of Disposition ,.1F" r..1 1P041.4P,2, 2 (address) W Cl) Q (section) /�(lot number) (grave number) GName of Sexton or Person in Charge of Premises /^ 1 ^ Sti Z / /p! se print/ in,[�_ Ill Signature Title DOH-1555(o7/18)p 1 of 2 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#