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Christie, Janice Mary
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle : ' Last 7xnale Janice Mary Christie Date of Death Age If Veteran of U.S.Armed Forces, 05/01/2020 85 Years War or Dates F Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital `p Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending U Circumstances Investigation UJ Medical Certifier Name Title Sean Bain MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 195 Burial Date, Cemetery,Crematory or Facility Name 05/04/2020 Pine View Crematorium Entombment Address ©Cremation Queensbury Hamlet,New York Donation 4 Removal Date Place Removed and/or and/or Held ~ Hold Address N O (L Date Point of U) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address In 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 or to Whom F— Remains are Shipped,If Other than Above Address M W IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/04/2020 Registrar of Vital Statistics `RQbert,4ndiretv Curtis(ElectronicaQy Signed) (signature) 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:Date of Disposition S( ZO Place of Disposition -P W L , 4 0�. 2 (address) W N IM (section) pot number (grave number/ Name of Sexton or Person in Charge of Premises kwL Z / ( se print/ W Signature �/� Title C DOH-1555(07/18)p 1 of 2 Public Health Law Sec`4145(2b) 01.3698 1 Receipt ' rr Human remains of delivered on , 20- Pine View Cemetery Representing the funeral home named,on burial permit Official Funeral Directors Reg.or License#