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Combs, Raymond H
11 311 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Raymond H.Combs Male Date of Death Age If Veteran of U.S.Armed Forces, 04/24/2023 97 Years War or Dates 1944-1946 F— Place of Death Hospital,Institution or W City,Town or Village Scotia Village Street Address Baptist Health Nursing And Rehabilitation Center,lnc 0 Manner of Death ❑X Natural Cause Accident Homicide OSuicide Undetermined Pending 111 Circumstances Investigation W Medical Certifier Name Title CI Sharon Lyng NP Address 297 N Ballston Ave,Scotia Village,New York 12302 Death Certificate Filed Village Of Scotia District Number Register Number City,Town or Village 4620 049 Burial Date Cemetery,Crematory or Facility Name 04/26/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York EIDonation 0 El Removal Date Place Removed and/or and/or Held F- Hold Address 0 O. Date Point of W❑Transportation by Common Shipment Carrier Destination III Disinterment Date Cemetery Address EiReinterment 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 a Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/25/2023 Registrar of Vital Statistics Maria Ann Schmitz(ECectronicaCCySigned) (signature) District Number 4620 Place Village Of Scotia I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z W Date of Disposition 14115 Place of Disposition (address/ W CC (section/ Xllot number/ (grave number) O Name of Sexton or Person in Charge of Pr 'ses /p se print/ Z W Signature Title 46""'4irt DOH-1555(o7/18)p t of 2 1 E 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#