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Baulsir, Jean Natalie
it/OS NEW YORKSTATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Jean Natalie Baulsir Female Date of Death Age If Veteran of U.S.Armed Forces, 01/21/2024 92 Years War or Dates (• Place of Death Hospital,Institution or Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital UJ 0 Manner of Death Undetermined Pendin Natural Cause Accident Homicide Suicide g W Circumstances Investigation W Medical Certifier Name Title O Catherine Dawson MD Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 50 Burial Date Cemetery,Crematory or Facility Name 01/31/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ElRemoval Date Place Removed and/or and/or Held ~ N Hold Address 0 n. Date Point of Cl)OTransportation Shipment Q by Common Carrier Destination Disinterment 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 Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/23/2024 Registrar of Vital Statistics &In Moran(E(ectronically Signed) (signature) District Number 4501 Place City Of Saratoga Springs I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z W Date of Disposition 21 I I 2 y Place of Disposition ��6✓S(,�! trK- MAMIL--- 2 (address) W Q (section) (lot number! (grave number) SName of Sexton or Person in Charge of re ' s `' 1 � (plse print/ W Signature Title `�,6/► ral DOH-1555(07/18)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#