Loading...
Rynasko, Edward q NEW YORK STATE DEPARTMENT OF HEALTH 7 I 1 Vital Records Section Burial - Transit Permit ni Name First Middle Last Sex Edward Simon Rynasko Male Date of Death Age If Veteran of U.S. Armed Forces,_ 10 / 29 / 2016 83 War or-Dates Iq5_3- /q '75 14 Place of Death Hospital, Institution or Z City, Town or Village Saratoga Springs Street Address Saratoga Hospital aManner of Death®Natural Cause 0 Accident 0 Homicide El Suicide 7Undetermined �Pending Circumstances Investigation tu Medical Certifier Name Title Todd Douglas Duthaler DO Address 211 Church St, Saratoga Springs, NY 12866 lii Death Certificate Filed District Number Register Number City, Town or Village Saratoga Springs 4501 .7 /1 ®Burial Date Cemetery or Crematory I 11 / 03 / 2016 Pine View Crematory ii ©Entombment • Address ECremation Queensbury, NY Date Place Removed ❑Removal and/or Held and/or Address 44 Hold 0 Date Point of Q Transportation Shipment E by Common Destination Carrier jj �Disinterment Date Cemetery Address El Reinterment Date Cemetery Address iinPermit Issued to Registration Number Name of Funeral Home Compassionate Funeral Care 00364 Address 402 Maple Ave. , Saratoga Sp. , NY 12866 iig Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address CC iii Permission is he b `y granted to dispose of the human rams dascribed ab ve as indicated. Date Issued i,I Registrar of Vital Statistics ] ,�„ (signature) District Number 4501 Place Saratoga Springs , New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: la Date of Disposition J//`1 hi Place of Disposition 'G pp ix Jt i_' e;m00 #- E (address) 0 LE (section) (lot number) (grave number) 0 l CI Name of Sexton or Person Charge of Premises `hit S�16 4 ! ( lease print) • i Signature Title C -M (over) DOH-1555 (02/2004)