Bedell, Patricia N
VDH-PHS-BTP-2011 VERMONT DEPARTMENT OF HEALTH Permit No. 1114
BURIAL-TRANSIT PERMIT
Permit for Removal, Disinterment and Reinterment
1. Decedent's Name 2. Sex 3. Date of Death
Patricia Joan Bedell Female August 29, 2011
4. City/Town of Death 5. Date of Birth 6. Place of Birth
41110 Rutland City January 24, 1941 Elizabeth,NJ
7. Name and Address of Funeral Director
Aldous Funeral Home,44 North Main Street,Rutland,VT 05701
PERMISSION REQUESTED FOR: (Check only one box and complete the appropriate section)
❑Temporary Storage or Donation(Section A) Cremation(Section C) 0 Burial or Entombment(Section D)
O Removal From Temporary Storage/Place of Donation or Disinterment(Section B) EL Removal From State(Section E)
SECTION A: IF TEMPORARY STORAGE OR DONATION IN VERMONT
1110 Name of Cemetery/Place or Donation Facility City/Town Date
PERMISSION GIVEN TO DISPOSE OF SAID BODY AS STATED ABOVE(Title 18,V.S.A. 5201)
Signature of Clerk/Deputy or Funeral Director City/Town Date
Signature of Sexton/Cemetery Official or Representative of Organization Receiving Donation Date
SECTION B: IF REMOVAL FROM TEMPORARY STORAGE/PLACE OF DONATION OR DISINTERMENT
Name of Cemetery/Place or Facility from which body is being removed City/Town Date
PERMISSION GIVEN TO DISPOSE OF SAID BODY AS STATED ABOVE(Title 18,V.S.A. 5201)
Signature of Clerk/Deputy or Funeral Director 1City/Town Date
Signature of Sexton/Cemetery Official Date
SECTION C: IF CREMATION IN VERMONT
N e of Crematorium City/Town Date l
e_ idi s . r�--�< �l9 r Q,Je e,/st.)t-c. !"/ V36/l i
PERMISSION GIVEN TO DISPOSE OF SAID DY AS STATED ABOVE(Title 18,V'S.A. 5201)
Signature of Clerk/Deputy o Ci own - Date
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SignatureeM Cremators um id Container Number Date
4110 SECTION D: IF BURIAL OR ENTOMBMENT IN VERMONT
Name of Cemetery City/Town Date
PERMISSION GIVEN TO DISPOSE OF SAID BODY AS STATED ABOVE(Title 18,V.S.A. 5201)
Signature of Clerk/Deputy or Funeral Director City/Town 1Date
Body was: ❑ Buried ❑ Entombed Date
110 Section Lot Number Grave Number Signature of Sexton/Cemetery Official
SECTION E: IF REMOVAL FROM STATE
Name of Cemetery or Place to where body is being taken City/Town,State or Country Date
Pine View Crematory Queensbury,NY August 30, 2011
PERMISSION GIVEN TO DISPOSE OF SAID BODY AS STATED ABOVE(Title 18,V.S.A. 5201)
Signature of Clerk/Deputy or Funeral Director City/Town 1Date
This permit is to be filed with the City/Town Clerk by the 10th day of the month following disposition.(Title 18 V.S.A.5215)