Drexel, Edgar Jacob . It y79
NEWYORKSTATE DEPARTMENTOFHEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle last Sex
Edgar Jacob Drexel Male
Date of Death Age If Veteran of U.S.Armed Forces,
06/10/2022 74 Years War or Dates Vietnam
i_ Place of Death Hospital,Institution or
Z City,Town or Village Thurman Town Street Address 534 High Street,Thurman Town,New York 12810
E+ Manner of Death ID Natural Cause ❑Accident Homicide ❑Suicide ElUndetermined ❑Pending
VCircumstances Investigation
Ui Medical Certifier Name Title
a Robert Love MD
Address
3 Irongate Center,Glens Falls,New York 12801
Death Certificate Filed Town of Thurman District Number Register Number
E
Cit ,Town or Village 5659 9
Burial Date Cemetery,Crematory or Facility Name
061
14/2022 Pine View Crematory
Entombment Address
Cremation Oueensbury Town,New York
Donation
DRemoval Date Place Removed
and/or and/or Held
— Hold Address
2
0:Iran sportation Date Point of
m by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Date Cemetery Address
DReinterment
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
F— Remains are Shipped,If Otherthan Above
S Address
CC
Permission is hereby granted to dispose of the human remains described above as Indicated.
Date Issued 06/14/2022 Registrar of Vital Statistics Cyntkac.7l (E.lctstmrcallj,Srg>wd)
(signature)
District Number 5659 Place Town Of Thurman
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: / A
Date of Disposition ON(ZZ Place of Disposition ` ',L, t�../T�
LIJ /address)
W
NtE (section) (lot.numbed (gm re number)
Q f P ��ii '�1v
O Name of Sexton or Person in Charge remises n m t�� +v✓ft
Z (p se print/
LLJ Signature Title CpF ��a
DOH 1555(07/18)pi 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#