Bishop, Betty Marie #/ 7
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Betty Marie Bishop Female
Date of Death Age If Veteran of U.S.Armed Forces,
02/05/2021 88 Years War or Dates /
1.- Place of Death Hospita,Institution or
Z City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare
p Manner of Death El Natural Cause El Accident ❑Homicide El Suicide El Undetermined El Pending
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0 Circumstances Investigation
Q Medical Certifier Name Title
Brandii Baker NP
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City,Town or Village Argyle 5750 13
Burial Date Cemetery,Crematory or Facility Name
02/09/2021 Pine View Crematory
❑Entombment Address
0 Cremation Quebury Town,New York
ElDonation
ZRemoval Date Place Removed
H and/or and/or Held
to Hold Address
0
CL 1-1 Date Point of
t/) ❑Transportation
p by Common Shipment
Carrier Destination
El Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
y^ Remains are Shipped,If Other than Above
`2 Address
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/09/2021 Registrar of Vital Statistics Slrelley91ckernon(EkctronicalySigned)
(signature)
District Number 5750 Place Argyle, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I—
WDate
Date of Disposition 2 IZ fi Place of Disposition .-1. ..7/L
(address)
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Cl)
ft (section) (lot /per) (grave number)
GName of Sexton or Person in Charge of emises M .n/Mfi
Z please pni�t/
Signature �� Title vWir'1j plM
DOH-1555(07/18)p i of 2
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
7.