Loading...
Sherman, Shirley Marie 4 in NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Shirley Marie Sherman Female Date of Death Age If Veteran of U.S.Armed Forces, 02/09/2024 73 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital LU p Manner of Death Natural Cause Accident El Homicide nSuicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title O 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 83 Burial Date Cemetery,Crematory or Facility Name 02/13/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation O❑Removal Date Place Removed and/or and/or Held H Hold Address 0 O. Date Point of U) Transportation p by Common Shipment Carrier Destination 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 ~ Remains are Shipped,If Other than Above 2 Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/12/2024 Registrar of Vital Statistics 9tMegan Wolin(E1ectronicaCCy Signed) (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: Z Date of Disposition 21 t)Iitil Place of Disposition ?St)e -cJ.) OEM 2 (address) W CC (section) (lot number) (grave number) fa• Name of Sexton or Person in Charge of Premises Z /p/ee e print) /" W Signature Title L 1' �M►1�.' DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) n1,795E3 Receipt Human remains of delivered on , 20 Pine View Cemetery-r !r Representing the funeral home named on burial permit Official Funeral Directors Reg. or License# —