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Walsh, Joan M 41" Zoi NEW YORK STATE DEPARTMENT OF HEALTH ,. LF Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Joan M.Walsh Female Date of Death Age If Veteran of U.S.Armed Forces, 02/22/2024 91 Years War or Dates 1„ 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 17 Pending W Circumstances Investigation W Medical Certifier Name Title G Courtney Stewart NP 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 108 ElBurial Date Cemetery,Crematory or Facility Name 02/23/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation aRemoval Date Place Removed and/or and/or Held N Hold Address 0 O. Date Point of N ElTransportation 5 by Common Shipment Carrier Destination Ei Disinterment Date Cemetery Address CI 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 H Remains are Shipped,If Other than Above 2 Address IIE ILLI O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/23/2024 Registrar of Vital Statistics Megan Nolin(ECectronicaICy 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 („2-24/2v,'L/ Place of Disposition ?FJ e 17 e.) Cr-14-te ry UJ 2 (address) W CD (section) number) (grave number) g Name of Sexton or Person in Cha/e., mises .� ar�o ni Z (please print) W Signature 17 Title ir.r‹. DOH-1555(07/18)p 1 of 2 ' 801'? 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#_ •