Reed, Bruce t 7 19 d
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Bruce E.Reed Male
Date of Death Age If Veteran of U.S. Armed Forces,
,,, 10/11/2017 69 Years War or Dates
Place of Death Hospital, Institution or
City, Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare
Manner of Death EtiNatural Cause ❑Accident Homicide ❑Suicide ❑Undetermined ❑Pending
Circumstances Investigation
Medical Certifier Name Title
a Jennifer Hayes MD
1,7 Address
4573 State Route 40,Argyle Town,New York 12809
Death Certificate Filed District Number Register Number
City, Town or Village Argyle 5750 25
❑Burial Date Cemetery or Crematory
10/13/2017 Pine View Crematory
❑Entombment Address
®Cremation Queensbury Town, New York—
Date Place Removed
❑Removal and/or Held
gmt and/or Hold Address
ti Date Point of
❑Transportation Shipment
E by Common Destination
Carrier
❑Disinterment Date Cemetery Address
El Reinterment Date Cemetery Address
Permit Issued to Registration Number
#tn Name of Funeral Home Alexander Baker Funeral Home 00037
Address
} 3809 Main St,Warrensburg,New York 12885
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Li,
Q"' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/13/2017 Registrar of Vital Statistics sfiefleyNicker/ton F(ectronicaaySigned
(signature)
f- District Number 5750 Place Argyle, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition jc/Ib 11 Place of Disposition F.„\J.,,,, A-a.-6,r,„,.-
{1 (address)
f
(section) // '(lot number) (grave number)
dName of Sexton or Person in Charge of Premi es UN N S/AA-1 ti
,dj ease print)
W Signature /.�► Title ( 1)1jW
(over)
DOH-1555 (02/2004)