Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Farndell, Jacqueline A
X NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Jacqueline A Farndell Female Date of Death Age If Veteran of U.S.Armed Forces, 02/14/2024 68 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital pManner of Death ❑X Natural Cause Accident 0 Homicide ESuicide Undetermined Pending ✓ Circumstances Investigation WW Medical Certifier Name Title a Howard Silverberg MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 95 Burial Date Cemetery,Crematory or Facility Name 02/16/2024 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York DDonation 6❑Removal Date Place Removed p and/or and/or Held N Hold Address 2 Date Point of t/)DTransportation by Common Shipment Carrier Destination Date Cemetery Address DDisintermentO 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 a Address CC W CI" Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/16/2024 Registrar of Vital Statistics sMegan.No(in(E(ectronica1Ty 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: Date of Disposition 217c111 Place of Disposition 1'34,�.,;_ j (()%6"\Rira i- LU 2 (address) W U) Q (section) 71.) (lotnumbe`=�`"i /gravenumber/ O Name of Sexton or Person in Charge of Premises r ' b Z6/9r pase print/ W Signature Title l ^ �l� DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) ; Receipt 1 1 Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License#