Sherman, Aaron s , # 71I
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Aaron Chadwick Sherman Male
Date of Death Age If Veteran of U.S. Armed Forces,
10/21/2017 88 Years War or Dates
Place of Death Hospital, Institution or
tiu City, Town or Village Glens Falls Street Address Glens Falls Hospital
p Manner of Death X❑Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
W Circumstances Investigation
Lu Medical Certifier Name Title
Matthew Loftus PA
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls 5601 545
❑Burial Date Cemetery or Crematory
10/23/2017 Pine View Crematory
; ['Entombment Address -
te[gCremation Queensbury Town, New York
Date Place Removed
❑
Removal and/or Held
Q and/or Address
NHold
49 Date Point of
ro❑Transportation Shipment
^_` by Common Destination
Carrier
Disinterment Date Cemetery Address
s.
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
is Remains are Shipped, If Other than Above
2, Address
Ce
Ill
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/23/2017 Registrar of Vital Statistics &6ertt7luau ECectronicadySigned
(signature)
District Number 5601 Place Glens Falls, New York
certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
WDate of Disposition /0/15' In Place of Disposition FinIV.-1 Ct'mc4"r'-
1a (address)
CO
(section) f lot number) (grave number)
i0 Name of Sexton or Person in Charge of Pre ises �```3St4 -4,4'
Z (pleas print)Signature v` Title t t�1�r,
19==t—
(over)
DOH-1555(02/2004)