SanFilippo, LilaN EW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First
Middle
Last
Sex
Lila Sanfilippo
Female
Date of Death
Age
If Veteran of U.S. Armed Forces,
09/25/2019
96 Years
War or Dates
Place of Death
Hospital, Institution or
City, Town or Village
Saratoga Springs
Street Address
Wesley Health Care Center Inc
Manner of Death
Natural Cause
LCJCircumstances
El Accident
Homicide
Suicide El Undetermined
Pending
Investigi
Medical Certifier
Name
Title
Eric Santell
NP
Address
131 Lawrence St, Saratoga Springs, New York 12866
Death Certificate Filed District Number
City, Town or Village Saratoga Springs 4501
❑ Burial Date Cemetery, Crematory or Facility Name
09/26/2019 Pineview Crematory
❑ Entombment
Address
Cremation
Queensbury Town, New York
Donation
Removal
Date
Place Removed
and/or
and/or Held
Hold
Address
Transportation
Date Point of
by Common Shipmei
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to
Name of Funeral Home Densmore Funeral Home Inc
Address
7 Sherman Ave, Corinth, New York 12822
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Register Number
505
Registration Number
00448
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/26/2019 Registrar of Vital Statistics John Paul Franck (Electronically Signed)
Idanatura)
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:
Date of Disposition 11 I I Place of Disposition �), i �rti(t� /U.—
Name of Sexton or Person in Charge of Premises
(PAWSe print)
Signature Title 1;W14
DOH-1555 (07/18) p 1 of 2
Public Health Law Sec. 4145(2b)
U12550
Receipt
Human remains of - �- delivered on rx , 20
Pine View Cemetery R presenting the funeral home named n burial permit
Official Funeral Directors Reg. or License # 9 ° k