Loading...
Angle, Ruth Ann 4, - # 3gZ NEW YORKSTATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex RuthAnn Angle Female Date of Death Age If Veteran of U.S.Armed Forces, 04/23/2021 74 Years War or Dates i_ Place of Death Hospital,Institution or W City,Town or Village Warrensburg Town Street Address Main Street,Warrensburg Town, New York 12885 Manner of Death ElNatural Cause ©Accident ❑Homicide ❑Suicide ElUndetermined ElPending lu Circumstances Investigation W Medical Certifier Name Title G Timothy Murphy Coroner Address 52 Haviland Avenue,Glens Falls,New York 12801 Death Certificate Fie D ,trict Number Register Number City,Town or Village ,,, arrensburg 5S60 14 ❑Burial Dad Cemetery,Crematory or Facility Name 04/28/2621 Pine View Crematory ❑Entombment Address ElCremation QueensburiTown,New York ❑Donation ZO ❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 O. 1-1 Date ` Point of U) ❑Transportation , p by Common Shipment Carrier Destination Date Cemetery Address ❑Disinterment Date Cemetery Address ❑Reinterment Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom -. Remains are Shipped,If Other than Above g Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/28/2021 Registrar of Vital Statistics TamefaM Lloyd(ECectronicattySigned) (signature) District Number 5660 Place Warrensburg, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition il I Zi J ZJ Place of Disposition 47..,�lL c` 2 (address) W NCC (section) ("jumper) (grave number) SName of Sexton or Person in Charge of Premises 1.i �w`A' it Z it (please pn W Signature Title OM"opt DOH-1555(07/18)p 1 of 2 n i Public Health Law Sec. 4145(2b) Li 1 1 � r-' - Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#