Barber, Beth E (1
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Beth E.Barber Female
Date of Death Age If Veteran of U.S.Armed Forces,
10/06/2020 66 Years War or Dates
F- Place of Death Hospital,Institution or
WCity,Town or Village Fort Edward Town Street Address 84 Patterson Road, Fort Edward Town, New York 12821
p Manner of Death 0 Natural Cause 0 Accident 0 Homicide 0 Suicide ❑Undetermined Pending
W
U Circumstances Investigation
Wp Medical Certifier Name Title
John Nelligan PA
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Fort Edward 5755 82
❑Burial Date Cemetery,Crematory or Facility Name
10/08/2020 Pine View Crematory
❑Entombment Address
gCremation Queensbury Town,New York
Donation
O Removal Date Place Removed
H and/or and/or Held
CO Hold Address
0
d Date Point of
CO 11 Transportation
p by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
f- Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/08/2020 Registrar of Vital Statistics _Aimee_falroney(Electronicall:y,Signed)
(signature)
District Number 5755 Place Fort Edward, 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 IQ/l_2o4.., Place of Disposition ,Je V e) cr0074
2 (address)
W
N
CC (section) ' (lotnymber/j (grave number)
p Name of Sexton or Person in Ch e of Premises � � �H►a ► (/JL //
Z / (please print)
W i�//
Signature �J /' (,ate Title Oee7 T. h
DOH-1555(07/18)p i of 2
Public Health Law Sec. 4145(2b) 01.4 086
Receipt
•
•
Human remains of • delivered on , 20
;�.
Pine View Cemetery Representing the funeral home named on,burial permit •
Official Funeral Directors Reg.or License# _-' i