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Cady, Gladys NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit a- Name First Middle Last Sex Gladys I. Cady Female • Date of Death Age If Veteran of U.S. Armed Forces, December 24,2012 77 War or Dates Place of Death Hospital, Institutior Rlfe Stanton Nursing & Rehabilitation City, Town or Village Queensbury Street Address Centre = Manner of Death X Natural Cause i l Accident Homicide Suicide Undetermined Pending :10Circumstances Investigation Ai Medical Certifier Name Title P. Patricia Auer Address ,Glens Falls,NY 12801 Death Certificate Filed District Number egister Number .; City, Town or Village Queensbury 5657 I icr1 ❑Burial Date Cemetery or Crematory December 28,2012 Pine View Crematory ill Entombment Address ©Cremation Quaker Rd.,Queensbury,NY 12804 Date Place Removed Z I ]Removal and/or Held O and/or Address H Hold N 0 Date Point of N I j Transportation Shipment a by Common Destination Carrier n Disinterment Date Cemetery Address I Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander-Baker Funeral Home 00035 Address =,,�p 3809 Main Street, Warrensburg,NY 12885 Name of Funeral Firm Making Disposition or to Whom I Remains are Shipped, If Other than Above Address lit , y Permission is hereb granted to dispose of the human remains described ab v. as indicated. Date Issued Imo-) i Registrar of Vital Statistics ( , C—�J (signature) District Number 5657 Place Queensbury I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: iti Date of Disposition 1.-Z') Place of Disposition �rJ�y,u,,, �re�►-c�crivM. W (address) Cl, c QName of Sexton or Person in Charge of Premises (section) / (io number) c (grave number) rho Z s J�In�/�' Z (p ase print) tu Signatureelt.0-- Title Cg2Ipil d- (over) DOH-1555 (02/2004)