Bammert, Margaret 11111
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Margaret S. Bammert Female
Date of Death Age If Veteran of U.S. Armed Forces,
November 14,2015 59 War or Dates
Place of Death Hospital, Institution or
Z. City, Town or Village T/O Warrensburg Street Address 121 River Street
pManner of Death X Natural Cause Accident I !Homicide Suicide Undetermined Pending
tti Circumstances Investigation
tu Medical Certifier Name Title
Address
Death Certificate Filed District Number Register Number�D
City, Town or Village T/O Warrensburg 5660
❑Burial Date Cemetery or Crematory
November 16,2015 Pine View Crematory
ElEntombment Address
Cremation 21 Quaker Rd., Queensbury, NY 12804
Date Place Removed
Z
Removal and/or Held
and/or Address
H Hold
N
O Date Point of
N n Transportation Shipment
p 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
Address
3809 Main Street,Warrensburg,NY 12885
Name of Funeral Firm Making Disposition or to Whom
Fes, Remains are Shipped, If Other than Above
2. Address
Ct
tt#;
U. Permission is hereby granted to dispose of the human rem ' s describe3i a ve as indicate.
Date Issued 5 Registrar of Vital Statistics _,Zr -
Q (signature)/
District Number 5660 Place T/O Warrensburg
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
w• Date of Disposition II ink Place of Disposition
(address)
0 (section) � (lot number)( (grave number)
Op Name of Sexton or Person in Charge of Premises C hr.j 3("di-
(pi�Z ase print)
Signature (/�®L Title ATX
(over)
DOH-1555 (02/2004)