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Maule, Barbara Jean
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vita[Records Name First Middle Last Sex Barbara Jean Maule Female Date of Death Age If Veteran of US.Armed Forces, 12/21/2019 89 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Glens Falls Street Address Glens Falls Hospital WMannerof Death ©Natural Cause Accident Homicide Suicide Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title Marvin Davidowitz MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 545 Burial Date Cemetery,Crematory or Facility Name 12/23/2019 Pine View Crematorium Entombment Address QCremation Queensbury Hamlet,New York r Donation dRemoval Date Place Removed and/or and/or Held E Hold Address 0 Transportation Date Point of d by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Barton-Mcdermott Funeral Home Inc 00141 Address 9 Pine St,Chestertown,New York 12817 Name of Funeral Firm Making Disposition orto Whom Remains are Shipped,If Other than Above Address iI w Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/23/2019 Registrar of Vital Statistics RQ6ertAndrew Curtis(Electronically Signed) (signature) District Number 5601 Place Glens Falls, New York I certify thatthe remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition r, 9 Place of Disposition /7, P_V, ) L/�w �a�G� U, -7—T (address) (section) /lotnumber) (grave number) Name of Sexton or Person in a of miser La G (please print) (� W Signature Title G/jo-rnel&I ` DOH-1555(o7/18)p 1 of 2 173 Public Health Law Sec. 4145(2b) 1 Receipt J Human remains of - r 6/ ' /` delivered on, . ' '` , 20 Pine View Cemetery Representing the i�uneral home named on burial permit Official Funeral Directors Reg.or License# s