Reiter, Judith NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
:.' Name First Middle Last Sex
Judith L. Reiter Female
Date of Death Age If Veteran of U.S. Armed Forces,
a; March 25,2017 51 War or Dates
iPlace of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
Manner of Death X Natural Cause Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
_a Medical Certifier Name Title
Eric Pillemer
Address
7J GFH,Glens Falls,NY 12801
Death Certificate Filed District Number Register Number
1 City, Town or Village Glens Falls 5601 ) 93
❑Burial Date Cemetery or Crematory
ri
Entombment Address
27,2017 Pine View Crematory
Address
®Cremation 21 Quaker Rd., Queensbury, NY 12804
Date Place Removed
Z I I Removal and/or Held
and/or Address
H Hold
N
O Date Point of
NTransportation Shipment
a by Common Destination
Carrier
I
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander-Baker Funeral Home 00037
Address
• a• 3809 Main Street,Warrensburg,NY 12885
1 Name of Funeral Firm Making Disposition or to Whom
1*1 Remains are Shipped, If Other than Above
Address
re
lit
Il.,• Permission is hereby granted to dispose of the human remains described above as indicated.
=,, Date Issued 3 l 2-7 /17 Registrar of Vital Statistics L�ewvyY,R. �J' s_
(signature)
District Number 5 60/ Place 6 &sr s k\Sr AI V
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition3 2 /7 Place of Disposition pm i✓L<, G -7
W (address(
CO
Ce (section) 11 (lot�nyv'ber) (grave number)
Q Name of Sexton or P. on ' Charge of Premises ,J i.-v 1&.✓r C?a •C
Z (please print)
W Signature Title G /"'' '�R ac-o�
(over)
DOH-1555 (02/2004)