Aguado, Pauline Ruth NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Pauline Ruth Aguado Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/04/2023 86 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address Glens Falls Hospital
WW Manner of Death Undetermined Pendin
Natural Cause Accident 1=1Homicide Suicide g
V Circumstances Investigation
W Medical Certifier Name Title
0 Asim Chaudry MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 5
Burial Date Cemetery,Crematory or Facility Name
01/05/2023 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
Removal Date Place Removed
and/or and/or Held
- Hold Address
N
0
O. Date Point of
fA❑Transportation
ES Common Shipment
Carrier Destination
oDisinterment 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
F. Remains are Shipped,If Other than Above
2 Address
Q
W -- -- -- —— - —_ — —
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/05/2023 Registrar of Vital Statistics _fegan.9lNogn gYectmnicail:y Signed/
(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:
Z Date of Disposition 7 Z023 Place of Disposition e_ V F e ,A) e rrnt 440
W
(address)
W
N
CC (section) (/ (lot number) (grave number)
0 Name of Sexton or Person in Charge of emises �!-�J r� 1)
Z (please print)
W Signature f Title Q Pslt,1,52S—
DOH-1555(07/18)p 1 of 2
•
I Public Health Law Sec. 4145(2b)
Receipt
Human remains of `f' ' delivered on • , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg. or License# ,'3
Town of Queensbury
Certification of Cremation
Pine View Cemetery and Crematory
This certifies that the remains of: Pauline Ruth Aguado
were cremated on January , 7 20 23 at the Pine View
(Month) (Day)
Crematorium, Queensbury,New York, and these are the cremated remains of said body.
Date of Death January , 4 20 23 Age 86
(Month) (Day)
Funeral Home Baker Funeral Home Registered No. 30
(Authorized Signature)
Aguado .
NAME Pauline Aguado 3 Age: 86
Lot Owner: Wesley Goodale
Lot# Mohawk 50 Grave# Center of
Case: urn grave 1 & 2
Died: 1 .4.2 3 Interred: 1 . 1 0.2 3
Funeral Home: Baker Fh
Cemetery: Pine View
GOODALE
Lot No. 50
Address 8 Sylvan Ave. Glens Falls, N.Y. 12801 Section No.
Owner Wesley Goodale Plot Mohawk
Date 9/7/83
Approx. 67 Superficial ft. @
Location Bounded on North by Kingsley & Marchiteno, South by Vacant. East by Gonda1P,
West by Vacant.
Corner Posts
Remarks
Deed No. (and changes) 1797
Payment Record Paid in Full 9/7/83
Record of Interments
t Agnes E . Goodale 11/12/98
2 I Wesley G. Goodale 8/23/96 d 1'
b S
i
(f:-
5 _ C
6 ! N
7I
aI
r.c/G S L t y st/iA rt c H ;+E.,v n
Form No. 01