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Baird, Helen NEW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT Imo' This permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Primary Registration District (Town, Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTI- FICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Registered No. 7 Town, Village Dist. No. ... '� County Warren or City Town of Queensbury,NY If city, give street address) Name of deceased Helen G. Baird Veteran No (If veteran,give name of War) Female Single, married,widowed, Widowed Dec. 2$ 1979 Sex or divorced (write the word) Date of Death Age 74 Years Months Days Birthplace New York State Cause of Death Myocardial Failure Certificate was signed by Sigmund Weiss M.D. Address 6 Elm St. , Hudson Falls, NY Place of Burial (or Removal) Town of Queensbury, NY (If body is to be temporarily held, fill in space later) 'Cemetery__Pine Vi.ew._Rec.. Vault Date of Burial Dec. 31 1979. . (If body is to be temporarily held, fill in space later) The CERTIFICATE OF DEATH containing the above stated particulars, having been presented to me, after careful examination, the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same for registration, have recorded it in my Local Record with the above stated Registered Number, and on the basis thereof I HERE- BY GRANT A PERMIT to Regan & Denny,Inc. Quaker Rd. , Glens Falls, NY (Name) (Address) the Undertaker to hold temporarily and . emove the body (Unlertaker or person having charge of corpse) (Int ove or other disp a of ( how)) Dated la— ‘ "-- 19..27 (Signed) Local Registrar This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local cemetery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required. FORM VS. 61. (REV. 6/631 18A2-781 ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE SL-7/Z2 Date of kv+-e-,f/' was /5) 19 (Interment or Cremation) (Name of Cemetery, OrematorMtm,-e ) Y , Section Lot No. Gravy No. (Signed) 4147(Person in in Charge) Address /9) Person in charge must return this Permit to the Registrar of his District within SEVEN (7) DAYS from above date. If no person is in charge, the FUNERAL DIRECTOR or UNDERTAKER MUST SIGN ABOVE STATEMENT, write across the face of the Permit the words "No person in charge," and FILE PERMIT WITHIN THREE (3) DAYS with the Registrar of District in which cemetery is located. SEXTONS, FUNERAL DIRECTORS and UNDER- TAKERS violating the law relative to the return of permits are liable to a penalty of NOT LESS THAN FIVE DOL- LARS NOR MORE THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The law will be enforced. Local Regis- trars are required, under penalty, to report violations thereof.