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Schiher, Shelly Lyn Qa.E.j) tf I()( NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Shelly Lyn Schiher Female Date of Death Age If Veteran of U.S.Armed Forces, 01/28/2024 54 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address St Peters Hospital pManner of Death El Natural Cause Accident Homicide Suicide Undetermined Pending C.) Circumstances Investigation CI Medical Certifier Name Title Marc Zemel PA Address 315 S Manning Blvd,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 0233 BurialE Date Cemetery,Crematory or Facility Name 01/30/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed H and/or and/or Held N Hold Address 0 0- Date Point of Cl)❑Transportation p by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address ElReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above S Address CC W 0- Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/30/2024 Registrar of Vital Statistics Kerry BartMioComew(E(ectronica1TySigned) (signature) District Number 0101 Place City Of Albany I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Z Date of Disposition 2 I I 1 21i Place of Disposition f'r , i 0 (,P . Ill 2 (address) W U) CC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises e•r /Ft Z - (pie se print) W Signature Title ‘Poe tflarl*Z- DOH-1555(07/18)pi of 2 l Public Health Law Sec. 4145(2b) �'-?9 u L Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#