Hall, Barbara T9 = `F 'c 3
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Barbara Hall female
Date of Death Age If Veteran of U.S. Armed Forces,
3-31 -201 1 57 War or Dates n a
I-. Place of Death Hospital, Institution or
Z City, Town or Village Saratoga Hospital Street Address Saratoga Hosptital
ILIManner of Death®Natural Cause 0 Accident 0 Homicide 0 Suicide Undetermined D Pending
tU Circumstances Investigation
ill Medical Certifier Name Title
0 Decrond Graco, MD
Address
59 Myrtle St. Saratoga Springs NY
Death Certificate Filed District Number Register Number
City, Town or Village 4-3-2 01 1 9 5 c ) /5 9
0 Burial Date Cemetery or Crematory
4-5-2011 Pine View Crematory
El Entombment Address
Cremation Quaker Rd: Queensbury, NY
Date Place Removed
z❑Removal and/or Held
3 and/or Address
H Hold
11)
0 Date Point of
tfin" Transportation Shipment
0 by Common Destination
Carrier
Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Regan Denny Funeral Home Registratio Number
Name of Funeral Home
Address
94 Saratoga Ave South Glens Falls, NY
Name of Funeral Firm Making Disposition or to Whom
.i!4 Remains are Shipped, If Other than Above
Address
i
ILI
` Permission is hereby granted to dispose of the human remains de_ _ibed above as indicated.
Date Issued Lipp Registrar of Vital Statistics �1 -P. 4ritAA,L11,
(signature)
District Number U 5 0) Place 'a �.0 .� ,_ Sda r,hJr
certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition LI-(,-(1 Place of Disposition "Pint U t.A., Calvet o r w
(address)
ta
CC (section) /) (lot numbar) (grave number)
ci Name of Sexton or P son in Char of Premises L �'e,eiris- -- r+ie4t
z (please print)
Signature 7201.... Title CP vn'l .
(over)
DOH-1555 (02/2004)