Bedell, Naomi NEW YORK STATE DEPARTMENT OF HEALTH r t 62
Vital Records Section Burial - Transit erm t
i 1 Name First Middle Last I Sex
Naomi T. Bedell Female
11 Date of Death ' Age If Veteran of U.S. Armed Fprces,
07/D /2017 93 War or Dates /�f 11
tPlace . Death Hospital, Institution or /3 / S_j
City, owrr Village Chester# Street Address Deceased' Residence
Man ter'of Death Eu Natural Cause 1.1 Accident El Homicide El Suicide ElUndetermined El Pending
ILI Circumstances Investigation
UJ Medical Certifier Name Title
G GLEN ANDERSON, RP -
Address
MAIN STREET Warrensburg, NY 12885
Death Certificate Filed District Number Register Number
City, Town or Village 6 ,(1 t t
❑Burial Date Cemetery or Crematory
Entombment 07/10/2017
Address
®Cremation
Date Place Removed
z,r1 Removal and/or Held
and/or Address
F. Hold
tl?' Date Point of
Et! OTransportation Shipment
by Common Destination
O Carrier
Disinterment Date Cemetery Address
IIReinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Barton-McDermott Funeral Home, Inc. 00141
Address
9 Pine St/P.O. Box 455 Chestertown NY 12817
Name of Funeral Firm Making Disposition or to Whom
.` Remains are Shipped, If Other than Above
2 Address
Permission is here y granted to dispose of the human remai s e cribed above as indicated.
Date Issued J 17 bl Registrar of Vital Statistics
g ature)
District Number 5.(o5--, Place ( air 6`-C e_5--\'c--
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
WDate of Disposition 71i11,7 Place of Disposition 4;nttj,,,, G,w.r•q,'jera,,`
(address)
WCo
re
(section) (lot number) (grave number)
p Name of Sexton or Person in Charge of Premises L s}'i'�" 3 P^'"{it
z ,l (please print)
W Signature u -b'' Title It FatX
(over)
DOH-1555 (02/2004)