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Allen, Janet Raye NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Janet Raye Allen Female Date of Death Age If Veteran of U.S.Armed Forces, 02/26/2024 63 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital 0 Manner of Death ❑X Natural Cause Accident ❑Homicide Suicide Undetermined Pending Circumstances Investigation WMedical Certifier Name Title G Gamal Khalifa 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 122 EBurial Date Cemetery,Crematory or Facility Name 02/29/2024 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation 8❑Removal Date Place Removed and/or and/or Held H Hold Address CD 0 0. Date Point of to Dransportation p by Common Shipment Carrier Destination El Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom F- Remains are Shipped,If Other than Above 2 Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/29/2024 Registrar of Vital Statistics Megan Wolin(ECectronica(rySigned) (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: / W~ e•-J C r p .C.'f q(_. Date of Disposition -�' �`� Place of Disposition �; ��� 2 (address) W t/) CE (section) ,/ (lotn mber/f (grave number) GName of Sexton or Person in Charge of P is ss kA%10,Q6 f1 t� a* z �iy (ptv�l�ase print) Ill Signature 1 Title �lf+f� DOH-1555(07/18)p 1 of 2 I _ 41 1 �vJ� 22 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#