McBride, Jamie NEW YORK STATE DEPARTMENT OF HEALTH ! Burial - Translt3 rmit
Vital Records Section
Name First Middle Last Sex
Jamie Jo McBride Female
Date of Death Age If Veteran of U.S.Armed Forces,
06/07/2013 55 War or Dates No
1+ Place of Death Hospital, Institution
Z; City ,Town or Village City of Albany or Street Address Albany Medical Center
a Manner of Death Natural Undetermined Pending
❑ ® Accident ❑ Homicide El Suicide ❑ ❑
LU' Cause Circumstances Investigation
W Medical Certifier Name Title
(3 Timothy Cavanaugh Coroner
Address
112 State Street Albany, NY 12207
Death Certificate Filed District Number Register Number
City,Town orVillage City of Albany 101 1126
Date Cemetery or Crematory
❑ Burial 06/17/2013 Pineview Crematory
❑ Entombment Address
® Cremation Queensbury, NY
Date Place Removed
Z Removal and/or Held
0 ❑ and/or Address
H Hold
Cl)
Q Date Point of
Cl.. Transportation Shipment
Cl) ❑ By Common a Carrier Destination
❑ Disinterment
Date Cemetery Address
El Date Cemetery Address
Reinterment
Permit Issued To Registration Number
Name of Funeral Home Compassionate Funeral Care, Inc. 00364
Address
402 Maple Avenue Saratoga Springs, NY 12866
HName of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Z Address
CC
LU
0- Permission is hereby granted to dispose of the human remains describe above as indicate� j�
Date 06/14/2013 Registrar of Vital Statistics opfu, c • ` Ji_Ilm
Issued signature)
District Number 101 Place City of Albany, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ZDate of Disposition b 11.4113 Place of Disposition P.. a.. 64,14101 tvb.—
I (address)
w
u)
re (section) (lot number) (grave number)
0
0
Z Name of Sexton or Person in Charge of Premises A syir ,4^t�I/ (please print)
Signature 74lr- . —_-_-, Title (Citt'11 iQ
(over)
DOH-1555 (02/2004)