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Wood, Wanda R -) NEW YORK STATE DEPARTMENT OF H EALTHLF �� Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Wanda R.Wood Female Date of Death Age If Veteran of U.S.Armed Forces, 10/03/2023 82 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Schuylerville Village Street Address 21 Spring Street, Schuylerville Village, New York 12871 W Manner of Death Undetermined Pending W El Natural Cause Accident Homicide Suicide Circumstances Investigation W Medical Certifier Name Title 0 Paul Byron MD Address 719 719 County Rt 60,Greenwich Town, New York 12834 Death Certificate Filed Village Of Schuylerville District Number Register Number City,Town or Village 4525 003 Burial Date Cemetery,Crematory or Facility Name 10/05/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation Z ❑Removal0 Date Place Removed and/or and/or Held Hold Address V) 0 f1 Date Point of (/) Transportation Q by Common Shipment Carrier Destination o 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 1— 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 10/04/2023 Registrar of Vital Statistics Wfe(ene Patterson(E(ectronicaCCySigned) (signature) District Number 4525 Place Village Of Schuylerville I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition JID )2:3 Place of Disposition Sui;.u;�r--� � 2 (address) W CC N (section) r(lot number) (grave number) 1E �.,,,►1r Name of Sexton or Person in Charge of Premises '� '16 J Z (please print) ,� W Signature Title fPM 'art DOH-1555(07/18)p i of 2 917346 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#