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Duell, Noma Veronica * # 20'g, NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Norma Veronica Duell Female Date of Death Age If Veteran of U.S.Armed Forces, 02/25/2024 91 Years War or Dates I—, Place of Death Hospital,Institution or Z City,Town or Village Granville Town Street Address Slate Valley Center for Rehabilitation and Nursing w Manner of Death Undetermined Pendin Natural Cause EElAccident Homicide Suicide g W C.) Circumstances Investigation W Medical Certifier Name Title CI Leah Terry NP Address 4573 State Route 40,Argyle Town, New York 12809 Death Certificate Filed Town Of Granville District Number Register Number City,Town or Village 5756 13 Burial Date Cemetery,Crematory or Facility Name 02/27/2024 Pine View Crematory Entombment — Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 CL Date Point of V) Transportation Q by Common Shipment Carrier Destination Ei Disinterment Date Cemetery Address 0 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 l— Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/26/2024 Registrar of Vital Statistics Jenny Linda M Marte((e(ECectronica((ySigned) (signature) District Number 5756 Place Town Of Granville I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: l— Z Date of Disposition 2 140 2k1 Place of Disposition 7i T c.,, CFI Al 1Z,^1511 ILLJ 2 (address) W N CC (section)(section) i7 (lot number) (grave number) 0 :::::: °' or Person in Charge of Prel ' eses// Title 1 - f7ie DOH-1555(07/18)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#