Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Ballard, Eileen Cora
44 1-73 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Eileen Cora Ballard Female Date of Death Age If Veteran of U.S.Armed Forces, 02/14/2024 90 Years War or Dates F- Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death 111Undetermined Pending � �Natural Cause Accident �Homicide Suicide iW Circumstances Investigation W Medical Certifier Name Title CI Melody Long PA Address 100 Park Street,Glens Falls, New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 94 Burial Date Cemetery,Crematory or Facility Name 02/16/2024 Pine View Crematory _Entombment--Address ©Cremation Queensbury Town,New York Donation Z❑Removal Date Place Removed and/or and/or Held - Hold Address 0 d Date Point of Cl) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment 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 i- Remains are Shipped,If Other than Above 2 Address C W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/15/2024 Registrar of Vital Statistics Megan Nolan(ECectronicaCCySigned) (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: Z Date of Disposition a- /7 Place of Disposition ae7 aet/i,/ (1.h:emiILI (address) W CC (section) (lot numbe) (grave number) 0 Name of Sexton or Person in Charge of Pr ise SE7eTykt') 1 e,01 (please print) W Signature �` f Title ©��i DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 3 g. Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License# -