Fisher, John Gregory NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
John Gregory Fisher Male
Date of Death Age If Veteran of U.S.Armed Forces,
02/03/2020 89Years WarorDates 1951-1954
F.. Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital
w Manner of Death 5-19 W Natural Cause Accident Homicide ❑Suicide Undetermined ❑Pending
V Circumstances Investigation
Q Medical Certifier Name Title
Heather Madigan DO
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 74
Burial Date Cemetery,Crematory or Facility Name
02/05/2020 Pine View Crematory
Entombment Address
RICremation Queensbury Town,New York
❑Donation
OZ ❑Removal Date Place Removed
and/or and/or Held
H N Hold Address
O
a Date Point of
to Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
(— Remains are Shipped,If Other than Above
2 Address
W
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/05/2020 Registrarof Vital Statistics 7olrn Paul!Franck(EkctroaicaQ Sagged)
(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:
Z Date of Disposition Z/S 1ZG Place of Disposition h y AV CIL%
LU
LU (address)
W
ir N (section) (lot number/ (grave number/
Name of Sexton or Person in Charge of remises is
Z (pl ase print)
W Signature f Title
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) '� 0 , 3 �
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# i,A