Probst, M Barbara NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
M. Barbara Probst Female
Date of Death Age If Veteran of U.S. Armed Forces,
1- August 7, 1998 82 War or Dates
2 Place of Death Hospital, Institution or
W City, Town, or Village Cambridge Street AddressMary McClellan Hospital
0 Manner of Death E Natural Cause Accident D Homicide OSuicide D Undetermined ❑ Pending
Circumstances Investigation
(J Medical Certifier Name Title
Matthew Pender MD
Address
1 Myrtle Ave. Cambridge, New York 12816
Death Certificate Filed District_Number Registe Number
City, Town or Village Cambridge (5 7
Date Cemetery or Crematory
❑Burial August 10, 1998 Pine View Crematory
Address
❑x Cremation Town of Queensburv, NY 12804-
Date Place Removed
0 0 Removal and/or Held
- and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
Carrier
a �Disinterment
Date Cemetery Address
❑Renterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home FLYNN BROS., INC. 00665
Address
80 MAIN STREET, GREENWICH, NY 12834
Name of Funeral Firm Making Disposition or to Whom
• Remains are Shipped, If Other than Above
W Address
0.
Permission is hereby granted to dispose of the human remains described above as indicate .
Date Issued ✓ $- g Registrar of Vital Statistics 7�y
(signature)
District Number 5',,ti Place Cambridge,New York
I certify that the remains of the decedent identified above were/1�.0 disposed of/in accordance with this permit on:
W Date of Disposition '/(,� Place of Disposition/ / � ,E4_ ezj -41� U/j4
2 (address
W
(section) (lot number) (wave number)
Z Name of Sexton or Person in Charge of P emises ,E .UIJ }/CD M i,T/?v4 L
(pleas print) e
111
Signature � Title r
PS !