Babbitt, Patricia NEW YORK STATE DEPARTMENT OF HEALTH : ' 'S if 11J.
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Patricia Babbitt Female
Date of Death Age If Veteran of U.S. Armed Forces,
April 3, 2013 82 War or Dates
�- Place of Death Hospital, Institution or
City, Town or Village Fort Edward Street Address Fort Hudson Nursing Home
Manner of Death I7T1
Eli Natural Cause 0 Accident 0 Homicide 0 Suicide 0 Undetermined 0 Pending
Circumstances Investigation
Medical Certifier Name Title
Maureen Hyland,
Address
IV 9 Carey Road Queensbury, NY 12804
Death Certificate Filed District Number Registerumber
City, Town or Village Fort Edward �" 5' - /
0 Burial Date Cemetery or Crematory
April 5, 2013 Pine View Crematory
0 Entombment Address
®Cremation Quaker Road Queensbury,NY 12804
Date Place Removed
- '❑ Removal and/or Held
and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
Carrier
3 Disinterment Date Cemetery Address
fgl
0 Reinterment
Date Cemetery Address
sa
r Permit Issued to Registration Number
ki Name of Funeral Home M. B. Kilmer Funeral Home 01079
- Address
82 Broadway, Fort Edward NY 12828
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
. Permission is her by ranted to dispose of the human em " descri ove as indicated.
ipe
Date Issued __ Registrar of Vital Sta "
/ (signature)
District Number `j 5 lace hv /42
, L r
,.,,,
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
,t= Date of Disposition 04/05/2013 Place of Disposition Quaker Road Queensbury,NY 12804
(address)
° (section) 4 (lot number) c (grave number)
Name of Sexton or Pers n in Charge f Premises ar, 3e1,46
ease print)
Signature L- Title CZetlyltatt
(over)
DOH-1555(02/2004)