DeVoe, Barbara f 1 it J R.,
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
" Name First Middle Last Sex
`¢= Barbara F. DeVoe Female
w Date of Death Age If Veteran of U.S. Armed Forces,
>> ` August 6,2014 82 War or Dates
1== Place of Death Hospital, Institution or
°Z` City, Town or Village Glens Falls Street Address Glens Falls Hospital
�' Manner of Death X Natural Cause Accident I I Homicide Suicide Undetermined Pending
W Circumstances Investigation
is Medical Certifier Name Title
Paul Bachman
Address
}s:- 3767 Main Street,HIHITh,Warrensburg,NY 12885
Death Certificate Filed District Number Register Number
!f,,:i City, Town or Village Glens Falls 5601 37t8'
❑Burial Date Cemetery or Crematory
August 7,2014 Pine View Crematory
❑Entombment Address
0 Cremation 21 Quaker Rd., Queensbury,NY 12804
Date Place Removed
Z
Removal and/or Held
and/or Address
H Hold
W
O Date Point of
NTransportation Shipment
p by Common Destination
Carrier
I I Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
1 Permit Issued to Registration Number
I 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
• Remains are Shipped, If Other than Above
• Address
1
la
Permission is hereby granted to dispose of the human emains de cribed bove assiinjdi <ted.
Date Issued dtO7 cpeW Registrar of Vital Statistics eQ� a
(signature)
District Number 5601 Place Glens Falls
H
I certify that the remains of the decedent identified above were •isposed of in accordance with this permit on:
Z Zi C
W Date of Disposition Obi Place of Disposition ,,,, •y {..-,,
2 (address)
W
CO
W (section) number (grave number)
Q Name of Sexton or Person in Charge of Premises lot
„ ... 'V {�-
'Z r (ple se print)
Signature L.— Title __ CaiEwcflit
(over)
DOH-1555 (02/2004)