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Colon, Joseph 6z -3 NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First middle Last Sex Joseph B. Colon male Date of Death Age If Veteran of U.S. Armed Forces, iilg 00 March 9, 2006 67 War or Dates 1955 - 1961 iiii Place of Death Hospital, Institution or 2 City, Town or Village Hudson Falls Street Address til :3 Manner of Death©Natural Cause 0 Accident 0 Homicide 0 Suicide nUndetermined ❑Pending ill Circumstances Investigation tu Medical Certifier Name Title 0 Address mi :: Death Certificate Filed District Number Register Number Mii City, Town or Village March 10, 2006 5726 6 - 2006 Date Cemetery or Crematory ❑Burial March 10,2006 Pineview Crematory Address ®Cremation Queensbury, NY Date Place Removed 0 Removal and/or Held •- and/or Address aHold Q Date Point of N❑Transportation Shipment a by Common Destination Carrier Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address :> Permit Issued to Registration Number Name of Funeral Home Maynard D. Baker Funeral Home 01194 ililiiil Address 11 LaFayette St. , Queensbury, NY 12804 `: <. Name of Funeral Firm Making Disposition or to Whom Piat Remains are Shipped, If Other than Above Address NI Permission is hereby granted to dispose of the human remains described above as indicated. Sii r/ Date Issued March 10, 206tegistrar of Vital Statistics ,,._. lj LL - indii�, (signare) Mii District Number 5726 Place Village Hudson Falls, NY I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 6 Date of Disposition P / "- /3 --� Place of Disposition ICE pi4) C R ti 4*D ki U 2 (address) uj U � (sscti��� �;(loinu�mbe�) / (grave number) Name of Sexton or Person in Charge of Premises CC��- Cs-�.Z z (please print) tfil Signature 624?.., Title C. E,A4 i --t-t) (over) DOH-1555 (9/98)