McNeill, Gerald FROM : ALEXANDER FUNERAL HOMES PHONE NO. : 5186232065 Sep. 12 2011 09:28AM P1
NEW YORK STATE DEPARTMENT OF HEALTH
y
Vita. Records Section Burial Transit Permit
' Name First Middle Last ! Sex j
{: . Gerald .f. McNeill Male
Date of Death ; Ag
e 1 if Veteran of U.B. Armed Forces,
September 6,2011 76 , War or Dates World War H_..
Place of Death I Hospital, Institution or
City, Town or Village Warrensburg 1_ Street Address Warrensburg Health center
Manner of Death 1 Ai Natural Cause 7 Accident l 'Homicide El Suicide 7 Undetermined r7 Pending
'AA `' —Circumstances '---'Investigation
Medical Certifier Name Title
p: Paul.Bachman —._... _. ..
;,.- Address
' i~rifiH.N :Warrensburg,NY_12885
Death Certificate Filed District Number ' Register Number
; City,Town or Village Warrensburg ! 5660
0 Bunal Date t Cemetery or Crematory
September 12,2011 Pine View Crematory
� mer>t
Address
®Cremation Quaker Rd..,,Queensbury,NY 12804
Date 1 Place Removed
O in Removal and/or Held
Address
'i Hold
itD
I r Dale Point Of
IN L. Transportation j Shipment
ip by Common Destination,
Carrier
i Date - -- - _.�, ._
• I�Disinterment ! Cemetery Address
Date _ I
I i Cemetery Address
fi Reinterment
`: Permit Issued to i Registration Number
,..,y•.,
, Name of Funeral Home Alexander-Baker Funeral Rome ,,..._ ._ . ... _
00035 __ ,
,:
:_' Address
w 3809 Main Street,Warrensburg, -,
Name of Funeral Firm Making Disposition or to Whom
8 Remains are Shipped, If Other than Above
Address
. Permission is hejeby ranted to dispose of the huma. , • described aglve a Indicated,
< � Date Issued �; ` f Registrar of Vital Steti _,A0• 16"- C i '
y. (Signature)
;, ',;;i District Number 5660 Place Warrensbulr
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 1(t3/lt Place of Disposit on 'f ostitc )Civrele/ice
W (address)
W. (sect(On) (lot num (grave numoer)
QName of Sexton or Per on in Charge o Premises Iir id 4 ` Witt
(tease Want►
Lii
Signature _� Title atceditop
(over)
DOH-1555(02/2004)
NEW YORK STATE DEPARTMENT OF HEALTH S
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Gerald J. McNeill Male
`, Date of Death Age if Veteran of U.S. Armed Forces,
September 6,2011 76 War or Dates World War II
Place of Death Hospital, Institution or
City, Town or Village Warrensburg Street Address Warrensburg Health Center
Manner of Death I X]Natural Cause I Accident I 'Homicide Suicide Undetermined Pending
U3, Circumstances Investigation
As Medical Certifier Name Title
Paul Bachman
Address
HHHN,Warrensburg,NY 12885
Death Certificate Filed District Number Register Number
City, Town or Village Warrensburg 5660
❑Burial Date Cemetery or Crematory
Entombment September 12,2011 Pine View Crematory
Address
®Cremation Quaker Rd., Queensbury,NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
Hold
N
0 Date Point of
coa.
Transportation Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
I
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander-Baker Funeral Home 00035
Address
3809 Main Street,Warrensburg,NY 12885
Name of Funeral Firm Making Disposition or to Whom
° -. Remains are Shipped, If Other than Above
X Address
Permission isheieby ranted to dispose of the huma email- described a ve as indicated.d.
Date Issued _ `( Registrar of Vital Stati cs 1�� � (7I L�7✓t �'""
(signature)
District Number 5660 Place Warrensburg
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
w Date of Disposition Place of Disposition
W (address)
N
p0 (section) (lot number) (grave number)
Name of Sexton or Person in Charge of Premises
Z (please print)
Signature Title
(over)
DOH-1555 (02/2004)