Mystery still surrounds the disappearance of the young mother as Black Country coroner Zafar Siddique returned an open verdict at her inquest but said he was “satisfied she is deceased”.
Earlier Mr Siddique heard how two"tiny" spots of her blood were found on a T-shirt in her loft.
Natalie - who had an 11-week-old son - has never been seen since leaving her home in Thornleigh, Lower Gornal, to buy cigarettes on September 1 2003.
An inquest was held to shed light on the 17-year-old’s disappearance after a request from West Midlands Police.
And today Mr Siddique concluded: “The medical cause of death remains unascertained.
"I don’t know from the evidence and circumstances her medical cause of death. But am satisfied she is deceased.”
Body never found
The hearing was told Aberystwyth-born Natalie's body has never been found despite extensive police activity since 2003, including searches of lakes, woodland and graveyards, while proof-of-life inquiries have all proved negative.
Coroner Saddique said: “Evidence shows she likely died at home or in the nearby area.”
West Midlands Police are treating Natalie’s disappearance as a ‘cold’ murder case.
Detective Sergeant Angela Baggott, of the West Midlands Police homicide review team, said Natalie was believed to have taken a bank card from the property but had left her mobile phone and handbag at home.
The officer said of the inquiry: "It's not closed. It's not a live investigation - as with all cold cases, they are reviewed periodically and any information that comes to the police will be acted upon."
Natalie was with her partner Kevin McCallum, the father of their son Rhys, before she left, it was heard.
Det Sgt Baggott told the court Mr McCallum ordered a taxi the day after she vanished.
“He got inside with four or five black bags, a push chair and a baby and asked to be taken to Brierley Hill according to a statement from the taxi driver,” she said.
The businessman - who was questioned for three days in 2004 on suspicion of murder - also told the inquest that he had not argued with Natalie on the day she went missing.
Mr McCallum said he could not recall getting into a taxi and the taxi driver’s account was a lie.
Coroner Saddique then asked him directly: “Did you play a part in the disappearance of Natalie Putt?” Mr McCallum replied: “No.”
During the inquest, Natalie's sister Rebecca Coggins paid tribute to her sibling, telling the court: "She was just one of those people who could walk into a room and light it up.
"People were always drawn to her. There is no way on this earth that she would have left her baby. That baby was her life ... was her entire world."
Natalie's father, David Putt, told the hearing he returned home from working in Telford and found that his daughter's income support and family allowance vouchers were still at the property and had not been cashed.
"My opinion is she would have taken the books," he told the court.
"If I was going to do a runner I would have taken every penny I had got but she left everything there."