Ehle, Joseph NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - �ranSlt Permit
Name First Middle Last Sex
Joseph E. Ehle Male
:; Date of Death Age If Veteran of U.S. Armed Forces,
tire September 8,2016 79 _ War or Dates
Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
Manner of Death Undetermined Pending
°� atural Cause Accident Homicide Suicide
Circumstances Investigation
w Medical Certifier Name Title
0 Cleaver
Address
F HIIHN
Death Certificate Filed District Number Register,Number
City, Town or Village C/O Glens Falls 5601 � u
❑Burial Date Cemetery or Crematory
❑Entombment September 13, 2016 Pine View Crematory
Address
❑x Cremation 21 Quaker Rd., Queensbury,NY 12804
Date Place Removed
Z
Removal and/or Held
and/or Address
L Hold
cn
O I Date Point of
coTransportation Shipment
p by Common Destination
Carrier _
Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander-Baker Funeral Home 00037
Address
'_ 3809 Main Street,Warrensburg,NY 12885
Name of Funeral Firm Making Disposition or to Whom
1- Remains are Shipped, If Other than Above
2 Address
W;
a Permission is hereby granted to dispose of the human mains described ab•ve as indi <ted.
s Date Issued el ' i >6/4, Registrar of Vital Statis 'cs aj,Q s ,.. A/ _ ,/-{'
(si.nature)
District Number 5601 Place 4.;—/-4
I— I certify that the remains of the decedent identified above were disposed of in accordant with this permit on:
Z
w Date of Disposition I'/51/. Place of Disposition IntOtcai t d-p('/, _
2 (address)
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co
0 (section) (lot number) (grave number)
Q Name of Sexton or Person in Charge of Premises b to_
3it4 l-
Zlease print)
Signature a Title (ZE MI Pa-
(over)
DOH-1555 (02/2004)