DeSanto, Rita Marie NEWYORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Rita Marie DeSanto Female
Date of Death Age If Veteran of U.S.Armed Forces,
02/11/2020 69 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 Homicide Suicide Undetermined Pending
W Circumstances Investigation
U
�W Medical Certifier Name Title
Maria Vivenzio DO
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 105
Burial Date Cemetery,Crematory or Facility Name
02/18/2020 Pine View Crematory
Entombment Address
X❑Cremation Oueensbury Town,New York
Donation
ZO Removal Date Place Removed
H and/or and/or Held
CO) Hold Address
O
0- Date Point of
CO)IFITransportation
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 Otherthan Above
Address
W
(L Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/18/2020 Registrar of Vital Statistics 70lrn rPaulq'ra-k(Electronicaf St wed)
(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:
H
Z Date of Disposition Z Igo Place of Disposition
Wez
2 (address)
W
N
W (section) (lot numb (grave number)
13 Name of Sexton or Person in Charge of P mises r.•��
Z Please print)
W Signature Title
DOH-1555 L
(07/18)p 1 of 2
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on ? , 20
i
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#