Babcock, Margaret Lucille � #3�g
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records '�
Name First Middle Last Sex
Margaret Lucille Babcock Female
Date of Death Age tf Veteran of U.S.Armed Forces,
05108/2022 77 Years War or Dates
H Place of Death Hospital,Institution or
W City,Town or Village Glens Falls Street Address Glens Falls Hospital
a Manner of Death El Natural Cause DAccident Homicide OSuicide DUndetermined ❑Pending
V1111 Circumstances Investigation
W Medical Certifier Name Title
o Gamal Khalifa MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
a5e
0 5601 259
Burial Date Cemetery,Crematory or Facility Name
05/11/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
pN Hold Address
0
a Date Point of
In Transportation
by Common Shipment
Carrier Destination
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
— Remains are Shipped,If Other than Above
N Address
CC
n' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 05/10/2022 Registrar of Vital Statistics Alvan Aran(Eli F1malljc*n4
(signature)
District Number 5601 Place City Of Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I—
W Date of Disposition 5/12172 Place of Disposition t,c� /4.—
2 (address)
W
Cl)ir (section) (lot number/ (grave number)
3,44
SName of Sexton or Person in Charge of P mises 45i...Z (pa print) r
W Signature Title gfillit
DOH-1555(07/18)pi of 2
Public Health Law Sec. 4145(2b) L.:,
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# ' ' S. a,..