Baker, Irene NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Biostatistics -Vital Records Section
Name First Middle Last Sex
Irene Wilson Baker Female
::: Date of Death A
...........................................................................
ge If Veteran of U.S.Armed Forces,
> April 24, 1990 77 War or Dates No
Place of Death Hospital, Institution or
iiiii City,Town or Village Glens Falls New York Street Address Glens Falls Hospital
....::.........::..
Cause of Death
Iti
Bilateral Broncho Pneumonia, Malignant Lymphoma
lu Medical Certifier Name Title
::G S. Richard. Spitzer M. D.
90 Address
South Street Glens Falls, New York 12801
::: Death Certificate Filed::::::............................................................... ..............
District Number Register Number
€> City,Town or Village Glens Falls, New York 5601 4=,71.3� '
Date > Cemetery or Crematory /
<: Burial April 27, 1990 Pine View Cemetery
['Cremation Address
, New............................. ........Quaker Road.::::...........(2ueensbtrrY..... .................York
Z Date Place Removed
Q:. ❑ Removal and/or Held
I > Address
to
D. Date Point of
(/)i ❑Transportation by Shipment
CommonCarrier . .................................................................................................................................................................................................
Destination
...........................................:::::Date::::::..................................................... .. .......................................................................................................
❑ Disinterment Cemetery Address
...........................................:.:::::Date:::::..................................................... .......................................................................................................
El Reinterment Cemetery Address
ni Permit Issued to Registration Number
Name of Funeral Firm Janes F. Singleton Inc. 01850
Address ............................................:.::::.:.::.......................................
314 Bay Road Queensbury, New York 12804
:.4 Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
iiig
Permission is hereby granted to dispose of the human r ns described a , e s " icated.
'` Date Issued April 27, 1990 Registrar of Vital Statistics ` -S_ /
(s' ature)
>` District Number 5601 Place Glens Falls, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I--
Date of Disposition 1-96 Place of Disposition 1'/�yr�fi�u• 1�F;411:74.: y� trittc--r=.v;,3/r/z) Al r
tLI2 (address)
uw cc (,sueii .A. I/ A.
;: (section) (lot number) (grave number)
aName of Se n o Person in Charge of Premises /f 'bw'r`1 67 /14sit/6=w .
z- (Please Pri )
: Signatur r1� �,�sj____- Title 5- c.,
DOH-1555 (9/86)p 1 of 2(formerly VS-61)
BAKER
cLF) Lot No. 11
Address Rolling Ridge, Glens Falls, N.Y. Section No.
Owner Irene W. Baker Plot Oneida
Date 2/19/79 ;.
loo Superficial ft. @ E $375.00
Location Bounded on the North by Road, East by Path, South by Vacant, West by Vacant
Corner Posts
Remarks
Deed No. (and changes) 1520
Payment Record Paid in full 2/19/79
Form No. 01
Record of Interments
1. Q+j f 5
2 ' Irene Wilson Baker 4/27/90 _ -d/1-qU 6
s Thy g A'_ Rnk.r (2/9n/79) �'%:19 7
4 8
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NAME Baker, Irene Wilson
Age: 77
Cause: Pneumonia-Malignant Nymphoma
Lot Owner: Irene W. Baker
Lot # 11 Oneida
Grave # 2
Case # Concrete
Died: 4/24/90
Interred: 4/27/90
Undertaker: Singleton