Sarro, Michele NEW YORK STATE DEPARTMENT OF HEALTI.1
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Michele L. Sarro Female
Date of Death Age If Veteran of U.S. Armed Forces,
07 / 12 / 2018 47 War or Dates N/A
}-- Place of Death Hospital, Institution or
ZCity, Town or Village Granville Street Address 248 New Boston Road
a Manner of Death® Natural Cause EI Accident E Homicide EiSuicide ❑ Undetermined ❑Pending
ItiCircumstances Investigation
W Medical Certifier Name Title
Q Christopher R. Mason MD
Address
102 Park St Cr Wood Cancer Center Glens Falls, NY 12801-4403
ii Death Certificate Filed District Number Register Number
'> City, Town or Village Granville 51/540
(Burial Date Cemetery or Crematory
07 / 16 / 2018 Pine View Crematory
El Entombment Address
ilia ECremation Queensbury, NY
Date Place Removed
❑• Removal and/or Held
and/or Address
Ilt Hold
O.
Cr Date Point of
Q Transportation Shipment
a by Common Destination
Carrier
`i Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care 00364
Address
402 Maple Ave., Saratoga Sp., NY 12866
siliik Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
ILI
Permission is hereby granted to dispose of the human remains described above as indicated.
>: Date Issued 1 I )L.Q I 1 Registrar of Vital Statistics
signature)
'!? District Number SI U, Place ranville , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ttit Date of Disposition i Ji$ Jig Place of Disposition f t.' �t •r..`
2 (address)
ILI
VI
Q (section) Aot number) r� (grave number)
• 0 Name of Sexton or Person in Charge f Premises 1ri� -� �� lt"
W 4 j , (plea e print) •
Signature / Title /4°144
•
(over)
DOH-1555 (02/2004)