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Wynkoop, Patricia A
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Patricia A.Wynkoop Female Date of Death Age If Veteran of U.S.Armed Forces, 01/25/2024 89 Years War or Dates I,.. Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital `p Manner of Death ❑X Natural Cause IllAccident Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title O Gwendolyn Morris-Dickinson PA 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 55 Burial Date Cemetery,Crematory or Facility Name 01/29/2024 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York Donation ❑Removal Date Place Removed and/or and/or Held H Hold Address O. O. Date Point of (/)ElTransportation p by Common Shipment Carrier Destination 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 1— Remains are Shipped,If Other than Above Address Q W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/29/2024 Registrar of Vital Statistics Megan Wolin(ECectronica((ySigned) (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: I— W Date of Disposition 1)30124 Place of Disposition j` T,ic"—.' /fl tTLL_ 2 (address) W CC (section) 7? (/nt number) (grave number) gName of Sexton or Person in Charge of Prem. i. A (lease prinfiloiTCR W Signature Title l DOH-1555(07/18)p 1 of 2 -7 Cos 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#