Loading...
Tasker, Gladys J (1,11) .., NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Gladys J.Tasker Female Date of Death Age If Veteran of U.S.Armed Forces, 02/09/2024 99 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Lake George Town Street Address 24 Shaw Road,Lake George Town,New York 12845 p▪▪ Manner of Death El Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title G Hilary Jones NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Lake George District Number Register Number City,Town or Village 5651 4 Burial Date Cemetery,Crematory or Facility Name 02/10/2024 Pine View Crematory Address ©Cremation Queensbury Town,New York Donation O Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 O. Date Point of N❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom F. Remains are Shipped,If Other than Above 2 Address 1r IL a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/12/2024 Registrar of Vital Statistics Patricia ItMc1Cinney-Schuster(ECectronicaCCy Signed) (signature) District Number 5651 Place Town Of Lake George I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W~ CAf Il'►�Tri Date of Disposition Z�It�Z� Place of Disposition `�j'tl E✓a�J �4L.- 2 (address) W CO (section) (lot number) (grave number) gName of Sexton or Person in Charge of remises n t+ , 7+ z ( se print) W lg Signature _ Title DOH-1555(o7/18)p 1 of 2 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#