Alden, Vera Margaret DEPARTMENT OF HEALTH LF) -
NEW Bureau of STATE BurialTransit Permit
of Vital Records
Name First Middle Last Sex
Vera Margaret Alden Female
Date of Death Age If Veteran of U.S.Armed Forces,
11/15/2022 93 Years War or Dates
F• Place of Death Hospital,Institution or
Z City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare
ILI
p Manner of Death ['Natural Cause Accident ❑Homicide OSuicide nUndetermined riPending
W Circumstances Investigation
W Medical Certifier Name Title
0 Brandii Baker NP
Address
4573 State Route 40,Argyle Town,New York 12809
Death Certificate Filed Town Of Argyle District Number Register Number
City,Town or Village 5750 59
Burial Date Cemetery,Crematory or Facility Name
11/17/2022 Pine View Crematory
Entombment Address —
ECremation Queensbury Town,New York
Donation
6EIDate Place Removed
Removal and/or Held
F- and/or
N
Hold Address
0
Date Point of
N❑Transportation Shipment
p by Common
Carrier Destination
El
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
i— Remains are Shipped,If Other than Above
Z Address
CC
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/17/2022 Registrar of Vital Statistics SlrelreyAickernon((/ctronica1'56ne42
(signature)
District Number 5750 Place Town Of Argyle
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition /// -Z7 Place of Disposition Pi 6 L)ietz.) Cr(7') f3
W (address)
W
NCC (section) I
(lot number) \ (gar number)
/ 1/471W.ni ' ,42 C_�/
SName of Sexton or Person in Charge of P mises V /print/ j
11) Signature �� 71- / /`it Title 01 7~
DOH-1555(o7/t8)p 1 of 2
•
01 6 Alti,
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
w Ce • •r Representing the funeral home named on burial permit
Funeral Directors Reg.or License#
Town of Queensbury
Certification of Cremation
Pine View Cemetery and Crematory
This certifies that the remains of: Vera Margaret Alden
were cremated on November , 19 20 22 at the Pine View
(Month) (Day)
Crematorium, Queensbury,New York, and these are the cremated remains of said body.
Date of Death November , 15 20 22 Age 93
(Month) (Day)
Funeral Home Baker Funeral Home Registered No. 904
(Authorized Signature)
ALDEN
NAME Vera Alden Age: 93
Lot Owner: Gladys Kim
Lot# New Hudson 41 . .3 Grave# 1 A
Case: Urn
Died: 1 1 . 1 6 .22 Interred: 1 2 .1 2.2 2
Funeral Home: Baker FH
Cemetery: Pine View