Leigh, Joyce NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Perm ifl 3
Name First Middle . Last Sex
Joyce W. Leigh Female
Date of Death Age 73 If Veteran of U.S.Armed Forces,
l- September 29, 2006 War or Dates
Z Place of Death Hospital, Institution or
I City, Town, or Village Chester Street Address23 Landon Hill Rd. Chestertown
D Manner of Death ®Natural Cause EI Accident Ei Homicide OSuicide El Undetermined [] Pending
W Circumstances Investigation
0 Medical Certifier Name Title
W Bryan Smead, M.D.
Q Address
Warrensburg Health Center, Warrensburg, NY 12885
>) Death Certificate Filed District Number Register Number
n City, Town or Village Chestertown tj
Date Cemetery or Crematory
❑ Burial October 2, 2006 PINE VIEW CREMATORY
Address
0 Cremation Adirondack, NY 12808-
Date Place Removed
0 0 Removal and/or Held
mi and/or Address
Hold
0 Date Point of
0 EI Transportation Shipment
L by Common Destination
ki Carrier
0 ❑ Disinterment
Date Cemetery Address
❑ Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Barton-McDermott Funeral Home, Inc. 00135
Address
9 Pine St. / P.O. Box 455, Chestertown, New York 12817
t Name of Funeral Firm Making Disposition or to Whom
x Remains are Shipped, If Other than Above
W Address
Permission is her y
(signature)
nted to dispose of the human =main des atov as indicated.
9 e
Date Issued i e . Registrar of Vital Statistics ' ,' f i - 61&7C .�
District Number L.5a j7 Place Town of Chester, Chestertown, New York 12817
6 I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
w Date of Disposition 14,/ /u 4o Place of Disposition P,A v,r 1,), (ro c. t v r: v—
(address)
#d
(section) (lot number) (grave number)
Name of Sexto r Person in Charge of Premises C c\ rr°t
W (please print)
Signature 71L Title Cr ` �T