Carter, Nancy NEW\ORK STATE DEPARTMENT OFHEALTH ��88�~��Q � ����)����~� D�*��8��^�
Vhu| Records Seo �n ��~~" "~=" Transit Permit
Name First Middle Last 5a
Nancy Ann Carter female
4/10/1990 46 VarorDates no
- - -----------------Hospital, institution or
City,Town ---------------
.Z Place of Death
NU City � Saratoga Street Saratoga Hospital
l
Manner of Death r-vl
ide
Undetermined
Pending
��� ---Cause- �-� Accident— �-� Homicide- �-� --- �-� C1noumo�mceo�-� Investigation
- -'
Medical Certifier Name Title
Address
District Numb7 Register Number
Death Certificate Filed
Date Citv of Saratoga Cemeter�Z Crema/ory
2 E] Removal and/or Held
----~~~---^----------
IL Date Point of
c� E] ''""=p" a"" ' "x Shipment
Common Carrier ------------------------------------------------ --
Destination
-- ------- /\������------------------------..--------
r El Disinterment --- '
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�l Reintormer8 --- '
Permit Issued to
Registration Number
...... Name of Funeral Firm Regan and Denny Funeral Service Tnc.
Address
Name of Funeral Firm Making Disposition or to Whom
re Shipped, If Other than Above
::Y:i Address
Permission is hereby granted to dispose of the human re ns; describ d abovta�dicated.
Date Issued
Registrar of Vital Statisti
District Number Place
~ |certify that the remains cf the decedent identified above were disposed of in accordance with this permit on:
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Da1eofDiopooh�n �/-/�� '��x Place Disposition / r^+ ' , y� y,u/z=~' �,w��~/�, �
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Vaddnmo �
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` (lot number) (grave number)
cc
Name ofSe "norP'moninCh'«e fPmmisou o=`4 L `` �^YA c�� /r ~; L-
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W Signature � / �� ' �� Th|o �� \jpT�
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