Loading...
Bahr, John NEW YORK STATE DEPARTMENT OF HEALTI- ! # li V1 Vital Records Section " Burial - Transit Permit Name First Middle Last Sex John William Bahr Male Date of Death Age If Veteran of U.S. Armed Forces, August 5, 2018 91 War or Dates Place of Death Hospital, Institution or City, Town or Village Fort Edward Street Address 1961 State Route 4 I Manner of Death ❑Natural Cause ❑ Accident ❑ Homicide X❑ Suicide ❑ Undetermined ❑ Pending Circumstances Investigation Medical Certifier Name Title Robert Lemieux, Address 219 Pope Hill Road Argyle, NY 12809 Death Certificate Filed District Number Register Nu,fi�er 'I City, Town or Village Fort Edward 6r16,5 T� ❑Burial Date Cemetery or Crematory August 7, 2018 Pine View Crematory ❑Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed ❑ Removal and/or Held and/or Address Hold Date Point of Transportation Shipment by Com k :1 mon Destination Carrier ❑ Disinterment Date Cemetery Address Date Cemetery Address ❑ Reinterment Permit Issued to Registration Number Name of Funeral Home M. B. Kilmer Funeral Home- FE 01079 Address 82 Broadway, Fort Edward NY 12828 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is er by granted to dispose of the human e v/ s described ab� e a in icated. Date Issued C�� I o�( Registrar of Vital Statistics V ikaDistrict Number5955 Place 1 �( f—ertL I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 08/07/2018 Place of Disposition Quaker Road Queensbury,NY 12804 (address) ice: t (section) (lot number) (grave number) Name of Sexton or Person in Charge of Premises ilkkt7pLfr 5444iif' (please print) Signature4 Title alfMgitIt (over) DOH-1555 (02/2004)