Munchgesang, Joyce t . L
' -It 37
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joyce A. Munchgesang Female
Date of Death Age If Veteran of U.S. Armed Forces,
April 8,2014 71 War or Dates
1.. Place of Death Hospital, Institution or
iZ City, Town or Village Lake George Street Address 25 Higgins Road
'p Manner of Death I XI Natural Cause Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
uj 0
G Medical Certifier Name Title
David Cunningham
Address
Iron Gate Center,Glens Falls,NY 12801
Death Certificate Filed District Number Register Number
City, Town or Village Lake George 5651 I _ 3
❑Burial Date Cemetery or Crematory
ID Entombment April 10,2014 Pine View Crematory
Address
❑x Cremation 21 Quaker Rd., Queensbury,NY 12804
Date Place Removed
Z Removal and/or Held
and/or Address
N Hold
O Date Point of
NTransportation Shipment
a by Common Destination
Carrier
I Disinterment 1 Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to I 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
i- Remains are Shipped, If Other than Above
2 Address
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W
O.
Permission is hereby granted to dispose of the human remains described abov s indi ated.
Date Issued Olt(i Q!?01C egistrar of Vital Statistics /'
(signatu e)
District Number 5651 Place Lake George
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
tu Date of Disposition Place of Disposition
IL (address)
Cl)
pW (section) (lot number) (grave number)
Name of Sexton or Person in Charge of Premises
Z (please print)
W
Signature Title
(over)
DOH-1555 (02/2004)