Gilooly, Paula NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Paula Gilooly Female
Date of Death Age If Veteran of U.S.Armed Forces,
02/09/2020 74 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Saratoga Springs Street Address Saratoga Hospital
p Manner of Death Natural Cause Accident 1:1Homicide Suicide Undetermined Pending
lL Circumstances Investigation
U
W Medical Certifier Name Title
Derek Smith MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 90
❑Burial Date Cemetery,Crematory or Facility Name
02/11/2020 Pine View Crematory
Entombment Address
K❑Cremation Queensbury Town,New York
Donation
ZO ❑Removal Date Place Removed
and/or and/or Held
H Hold Address
N
O
d Date Point of
to ❑Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
jr-1 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
Address
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/11/2020 Registrar of Vital Statistics ,7olen Paul!ranc,E(Ekctronrcad Sowed)
(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:
W Date of Disposition Z III Ito Place of Disposition OL
LU (address)
W
N (section) (!at numbe (grave number/
aName of Sexton or Person in Charge of Premises r-
Z (pi ase print)
W Signature C Title
DOH-1555(07/18)p 1 of 2
♦ _ ray '`
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on 120
Pine View Cemetery Representing the funeral home named urkal-permit
Official Funeral Directors Reg.or License# "f