Rathbun, Beatrice PILx
NEW YORK STATE DEPARTMENT OF HEALTH k Burial - Transit Permit
Vit?I Records Section
Name First Middle Last Sex
BEATRICE W. RATHBUN FEMALE
Date of Death Age If Veteran of U.S.Armed Forces,
JAN. 20, 2006 83 War or Dates
P• lace of Death Hospital, Institution
City,Town or Village City of Albany or Street Address ALBANY MEDICAL CENTER
Manner of Death Natural ❑ Undetermined ❑ Pending
® Cause ❑ Accident ❑ Homicide ❑ Suicide
Circumstances Investigation
Medical Certifier Name Title
LEON KUSHNIR MD
Address
ALBANY MEDICAL CENTER, NEW SCOTLAND AVE., ALBANY, NY 12208
D• eath Certificate Filed District Number Register Number
=J City,Town or Village City of Albany 101 119
El Cemetery or Crematory
Burial JAN. 23, 2006 PINE VIEW CREMATORIUM
Addres
• y= ® Cremation QUEENSBURY, NEW YORK
Date Place Removed
Z' Removal and/or Held
4< ❑ and/or Address
`"'' Hold ,.
Cl,
, 3 Transportation Date Point of
CO, ❑ By Common
Shipment
Carrier Destination
❑ Date Cemetery Address
• Disinterment
❑ Reinterment
Date Cemetery Address
Permit Issued To Registration Number
Name of Funeral Home BEGAN & DENNY FUNERAL HOME 01519
Address
,: 53 QUAKER RD., QUEENSBURY, NY 12804
`_ Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human remains describe ab ve as indicated/ )
Date JAN. 20, 2006 � �
Issued Registrar of Vital Statistics C'-rL�`'
(signature)
District Number 101 Place City of Albany, NY
1 I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 1- 2 3_.C.1, Place of Disposition / }AJ C C" (-(2 u4 R.,\ \-)"2. -1,
-10 (address)
1 =
' (section) /� (lot number) (grave number)
WName of Sexton or Person in Charge of Premises Gi ii..a-all C_9 j� "
(please print)
/Signature Title t, `c -/K a.÷'0 S
(over)
DOH-1555(9/98)
RATHBUN (14.9 Lot No. 4 7
[dress Moon Hill Road R . D. Take George , NY 12845 Section No. F
crier Harold & Beatrice Rathbun Plot Mohican
ite 9/3/92
Approx . 33 Superficial ft. @
cation Bounded on North by Stockwell , South by Vacant , East by Vacant ,
West by Vacant .
Tner Posts
marks
!ed No. (and changes) 2469
yment Record Paid in Full 9/3/92
cord of Interments
Harold A. Rathbun 7/30/93 (CR.��`,', ) =i
BEATRICE W. RATHBURN 1/30/06 (CREM) V v
19
+3 � \.0►\\16()15 iI • ,)7 ( C' ft I
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Rai
r No. 01 BuR`GL
)IA ME RATHBUN, BEATRICE W.
()L:t)
Age: 83
Cause:
Lot OwnerkAROLD & BEATRICE RATHBUN
Lot # 47-E MOH I CAN
Crave # 2
Case # CREMATION (CERAMIC)
Died: 1/20/06
Interred: 1/30/06
Undertaken
EGAN & DENNY