Constantine, Joyce NEW YORK STATE DEPARTMENT OF HEALTH 4 `
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joyce Monica Constantine Female
Date of Death Age If Veteran of U.S. Armed Forces,
July 22,2018 49 War or Dates
Place of Death Hospital, Institution or
,Z° City, Town or Village Granville Street Address Haynes House Of Hope
`AU
Manner of Death Undetermined Pending
X Natural Cause Accident Homicide Suicide
w` Circumstances Investigation
at Medical Certifier Name Title
Suzanne Bergin MD
Address
- 3767 Main Street,Warrensburg,NY 12885
Death Certificate Filed District Number Register Number
a City, Town or Village Granville gig-Co a 8
❑Burial Date Cemetery or Crematory
0 Entombment July 25,2018 Pine View Crematory
Address
❑x Cremation 21 Quaker Rd., Queensbury,NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
Hold
0 Date Point of
mTransportation Shipment
G 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
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2: Address
ir
Permission is hereby granted to dispose of the human remains described�Q above as indicated.
A Date Issued 7-24-18 Registrar of Vital Statistics d, auct
(sig ature)
__ District Number 51 S(� Place T/O Granville,NY i
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
w' Date of Disposition 9 d-$-1,5' Place of Disposition pin.C,oLtJ cdit"/Q('y
2' (address)
W
N
r (section) (lot number) (grave number)
pName of Sexton or Person in Charge of Premises ye ',ivy SGu:k.S
`Z 1 (please print)
*„,":..
Signature i" Title G(�r'ct}o1
(over)
DOH-1555 (02/2004)