Wright, Dorothy P ( ) It -.)7 S
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Dorothy P.Wright Female
Date of Death Age If Veteran of U.S.Armed Forces,
09/10/2022 78 Years War or Dates
F. Place of Death Hospital,Institution or
Z City,Town or Village Schenectady Street Address Ellis Hospital
p Manner of Death []Natural Cause []Accident []Homicide DSuicide []Undetermined Pending
W f 'Circumstances Investigation
W Medical Certifier Name Title
0 Bernard Ng MD
Address
1101 Nott St.,Schenectady,New York 12308
Death Certificate Filed City Of Schenectady District Number Register Number
City,Town or Village 4601 802
EDateBurial
Cemetery,Crematory or Facility Name
09/14/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
0 Removal Date Place Removed
and/or and/or Held
f- Hold Address
CO
0
a Date Point of
to Transportation
p by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment 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
F Remains are Shipped,If Other than Above
Address
CC
W
a. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/13/2022 Registrar of Vital Statistics Samanta 9Z,fMykoo(EtectmnicallySigned)
/signature)
District Number 4601 Place City Of Schenectady
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I—
Z Date of Disposition ci I 1 I n Place of Disposition '/
n Zi---
W
2 (address)
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NCC (section) (lot number) smwt, (grave number)
il
0 Name of Sexton or Person in Charge of remises At*Z----(;
print) /+
uJ Signature ,t Title ['rA rnH��
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# .�