Singer, Katherine NEW YORK STATE DEPARTMENT OF HEALTH' ‘ g
s-s
Vital Records Section Burial - Transit Permit
1
Name First Middle Last Sex
Katherine K. Singer Female
Date of Death Age If Veteran of U.S. Armed Forces,
July 3,2018 71 War or Dates
} Place of Death Hospital, Institution or
Z City, Town or Village Chester Street Address 6299 State Rt. 9
pManner of Death I XI Natural Cause I I Accident Homicide , Suicide ., Undetermined Pending
2Circumstances Investigation
W Medical Certifier Name Title
13 Timothy E.Murphy Mr
Address
52 Haveland Ave.,Glens Falls,NY 12801
Death Certificate Filed District Number — Register Number
City, Town or Village , Chester 5652 /0
El Burial Date / Cemetery or Crematory
July 9,2018 Pine View Crematory
0 Entombment Address
®Cremation 21 Quaker Rd., Queensbury, NY 12804
Date Place Removed
Z Removal and/or ld
and/or Address
—I— Hold
N
0 Date Point of
y I I Transportation Shipment
p by Common Destination
Carrier
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 Street,Warrensburg,NY 12885
"4, Name of Funeral Firm Making Disposition or to Whom
_1 Remains are Shipped, If Other than Above
2' Address
tt
Ut
0 Permission is hereby granted to dispose of the human ren ai s described above as indicated.
Date Issued '7—` --CIO(g- Registrar of Vital Statistics i, 0/1A- ''
(signature)
Cr-
District Number 5652 Place Chester
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
W Date of Disposition `7//o gig Place of Disposition f U.— 4414,,
W (address)
N
CC
(section) t nu ber) (grave number)
pName of Sexton or Person in Charge of Premises r. St--Kd
Z (plea9e print)
w Signature G✓( Title afi A'1-
(over)
DOH-1555 (02/2004)