Walker, Joan Marie 11- $ g
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Joan Marie Walker Female
Date of Death Age If Veteran of US.Armed Forces,
01/24/2023 89 Years War or Dates
H Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address Glens Falls Hospital
p Manner of Death El Natural Cause Accident Homicide Suicide 0Undetermined Pending
Circumstances Investigation
E Medical Certifier Name Title
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 45
EdBurial Date Cemetery,Crematory or Facility Name
01/26/2023 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
Z❑Removal Date Place Removed
and/or and/or Held
~ Hold Address
N
0
O. Date Point of
(I) Transportation Shipment
S by Common
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
1— Remains are Shipped,If Other than Above
2 Address
Ix
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/25/2023 Registrar of Vital Statistics Megan No('n(E(ectronicalySigned)
/signature/
District Number 5601 Place City Of Glens Falls
I certify that the remains of the decedent identified above weresosed of in accordance with this permit on:
Date of Disposition I I z- 173 Place of Disposition E(L ZfOr
W (address)
lW
CO (section) ; (lot number) (grave number)
gName of Sexton or Person in Charge of Premises A
Z )L(please print) nWSignature1_!,
Title ((?l` �A t[
DOH-1555(o7/18)p 1 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#