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Turi, Patricia
NEW YORK STATE DEPARTMENT OF HEALTH 0. VI 14 GK? Vital Records Section Burial - 1 ransit Permit Name First Middle Last Sex ``"" Patricia ;°s' A. Turi Female .. Date of Death Age If Veteran of U.S. Armed Forces, v = December 3,2016 58 War or Dates Place of Death Hospital, Institution or Z. City, Town or Village Glens Falls Street Address Glens Falls Hospital • Manner of Death X Natural Cause Accident I I Homicide Suicide Undetermined Pending US Circumstances Investigation 8 Medical Certifier Name Title Cleaver �e Address HHHN Death Certificate Filed District Number Registerber City, Town or Village C/O Glens Falls 5 �/ ❑Burial Date Cemetery or Crematory ❑Entombment December 5,2016 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 Cl) O Date Point of 1351 'Transportation Shipment a by Common Destination Carrier _ Disinterment Date Cemetery Address n Reinterment Date Cemetery Address _: ' Permit Issued to Registration Number ,, Name of Funeral Home Alexander-Baker Funeral Home 00037 t°=aj' Address IV.. 3809 Main Street,Warrensburg,NY 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 huma remains described�bove as in, =d. Date Issued - Registrar of Vital Statistics 67_(7�Jy, d:!/ / :,:: (signature) District Number , 5 oC I Place C/O Glens Falls I certify that the remains of the decedent identified above we disposed of in accordance with this permit on: Z -- ui Date of Disposition /tf s/li, Place of Disposition eiL ejet. c W (address) N ce (section) (lot number) (grave number) O• Name of Sexton or Person in Charge o Premises �r, r 59141I Z please print) W Signature a Title (Iztftlii1t (over) DOH-1555 (02/2004)