Bechmann, Harold E -11 r" # .1l1 ll
NEW YORKSTATE DEPARTMENT OF H EALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Harold E.Bechmann Male
Date of Death Age If Veteran of U.S.Armed Forces,
09/19✓2022 81 Years Waror Dates
1.. Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address Glens Falls Hospital
�+ Manner of Death EINaturalCause Accident El Homicide Suicide ❑Undetermined ❑Pending
In Circumstances Investigation
W Medical Certifier Name Title
C Marcllle Labban MD
Address
100 Park St,Glens Fails,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
Cit ,Town or VillageEi
5801 479
Burial Date Cemetery,Crematory or Facility Name
0 d d re s 022 Pine View Crematory
Entombment Address
Cremation Oueensbury Town,New York
Donation
0❑Removal Date Place Removed
F and/or and/or Held
N Hold Address
0
n. Date Point of
N Transportation Shipment
Q by Common
Carrier Destination
Date Cemetery Address
Disinterment
EI
Re interment
Date Cemetery Address
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
1— Remains are Shipped,If Other than Above
2 Address
Q
W
CL
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/20/2022 Registrar of Vital Statistics Megan groan(E4sctronrca(Signsd)
/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:
Date of Disposition 1laI ii Place of Disposition l '^'`V -- / (
W (address)
W
NCC (section/ (lot number) (grave number)
a Name of Sexton or Person in Charge of P s
4 P)1L— ...>*--11(1
z 0ase print/
W Signature _ Title ��
DOH-t555(o7/18)p 1 of 2
f '1 7
Public Health Law Sec. 4145(2b)
1
Receipt
Human remains of delivered on , 20 7
_
/11
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#-''".�`'