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Smith, Linda Ann gare NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Linda Ann Smith Female Date of Death Age If Veteran of U.S.Armed Forces, 01/19/2024 81 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Glens Falls Street Address Glens Falls Hospital 'p Manner of Death ❑^ Natural Cause Accident Homicide [] [] [] Suicide Undetermined Pending I (Circumstances I Investigation Medical Certifier Name Title n Emily Rapasadi PA Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 44 []Burial Date Cemetery,Crematory or Facility Name 01/23/2024 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York IIIDonation 0 Removal Date Place Removed and/or and/or Held Hold Address 0 0. Date Point of V1[]Transportation by Common Shipment Carrier Destination ODisinterment 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 1 Remains are Shipped,If Other than Above 5 Address CC W C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/23/2024 Registrar of Vital Statistics lviegan Wolin((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 Pit 171 Place of Disposition ��►6us6J C > IrtokT�— (address) W CC (section) 7 (lot numb' (grave number) Name of Sexton or Person in Charge of Premises G e- z lease print) f/ W Signature C� Title 4I11Ur' DOH-1555(07/18)p 1 of 2 0 r) 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#