Colton,Joan P. T "1
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit{ VV
Bureau of Vital Records
Name First Middle Last Sex
Joan P.Colton I Female
Date of Death Age If Veteran of U.S.Armed Forces,
04/20/2020 85 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Cohoes Street Address Eddy Village Green
C1 Manner of Death ®Natural Cause Accident Homicide Suicide Undetermined Pending
V Circumstances Investigation
W Medical Certifier Name Title
Donald Jue MD
Address
421 W Columbia St,Cohoes,New York 12047
Death Certificate Filed District Number Register Number
City,Town or Village Cohoes 0102 59
❑Burial Date Cemetery,Crematory or Facility Name
04/24/2020 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
ZO Removal Date Place Removed
and/or and/or Held
N
Hold Address
O
d Date Point of
fn ❑Transportation
p by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander Baker Funeral Home 00037
Address
3809 Main St,Warrensburg,New York 12885
Name of Funeral Firm Making Disposition or to Whom
li.- Remains are Shipped,If Other than Above
2 Address
cc
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/23/2020 Registrar of Vital Statistics Gori,Ann 7ando(ECectronicallySiyned)
(signature)
District Number 0102 Place Cohoes, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition 4/-2 y.2,0W Place of Disposition 7 �Qu ,c� Z7
2 (address)
W
N (section) (lot number) (grave number)
0 Name of Sexton or Person' rqe of Premises
Z (please print)
LU Signature Title zy
DOH-1555(07/18)p t of 2
Public Health Law Sec. 4145(2b) 0 1 S 6 1 8
Receipt
Human remains of delivered on , 20
I' J
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#