Neuffer, Hedwig i b37
NEW YORK STATE DEPARTMENT OFIHEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
te-
• Hedwig Neuffer Female
Date of Death Age If Veteran of U.S. Armed Forces,
08/17/2017 82 Years War or Dates
Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
Manner of Death el Natural Cause Accident ❑Homicide ❑Suicide ❑Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
Suzanne Rayeski DO
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
• City, Town or Village Glens Falls 5601 439
El Burial Date Cemetery or Crematory
08/24/2017 Pine View Crematory
❑Entombment Address
®Cremation Queensbury Town, New York
Date Place Removed
❑Removal and/or Held
and/or
Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
Carrier
Disinterment Date Cemetery Address
Date Cemetery Address
❑Reinterment
Permit Issued to Registration Number
• 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
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/21/2017 Registrar of Vital Statistics MenACurtis ECectronicaffySigned
(signature)
District Number 5601 Place Glens Falls, New York
• I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition s)25-f n Place of Disposition 1, �.w �-avrn 4f r:w
•- (address)
(section) (lot number) (grave number)
'. Name of Sexton or Person in Charge of Premises t Ans'# S��414
`'"• Signature i Title (p/ se print)PE"IAW-
(over)
DOH-1555 (02/2004)