Wettig, Anna NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit ermit
Name First Middle Last j Sex
Anna May Wettig Female
Date of Death Age If Veteran of U.S. Armed Forces,
May 17,2011 I 93 War or Dates
Place of Death Hospital, Institution or
. City, Town or Village Glens Falls Street Address Glens Falls Hospital
US
im Manner of Death n Natural Cause Accident Homicide n Suicide Undetermined Pending
W Circumstances Investigation
, Medical Certifier Name Title
45, Paul Bachman,MD
Address
* Warrensbury,NY
Death Certificate Filed District Number Registe NNlr
`: City, Town or Village Glens Falls,NY 5601
❑Burial Date Cemetery or Crematory
May 19,2011 Pine View Crematory
❑Entombment Address
❑X Cremation Quaker Road, Queensbury, NY 12801
Date Place Removed
Z Removal 1 and/or Held
and/or Address
H Hold
W
O Date Point of
O.
Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
1-1 Reinterment Date 1 Cemetery Address
1
', Permit Issued to Registration Number
• Y° Name of Funeral Home Regan & Denny Funeral Home 01464
Address
53 Quaker Road, Queensbury,NY 12804
• Name of Funeral Firm Making Disposition or to Whom
$ Remains are Shipped, If Other than Above
',a^; Address
rZ
Permission is hereby granted to dispose of the human mains scribed ve as indic ted.
• Date Issued 65'/f,.,A0/7 Registrar of Vital Statistics 0
(signature)
District Number 5601 Place Glens Falls,NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z �
Lu Date of Disposition i -LPins
+'
o-1( Place of Disposition tc4..) Crrn,.<toeau--
W (address)
Cl)
O (section) got number (grave number)
pName of Sexton or Pert n in Charge of Premises711(,s1 Air- tea-
Z (please print)
W �,[ C(l p t Signature 7 -?)L_ Title 60,
(over)
DOH-1555(02/2004)