Pyle Jr., Bert tr -. Tog
NEW YORK STATE DEPARTMENT OF HEALTH Burial Transit Permit
Vital Records Section
Name First Middle Last Sex
Bert William Pyle, Jr. Male
ni Date of Death Age If Veteran of U.S. Armed Forces,
01 / 30 / 2018 82 War or Dates 1958-1961
}- Place of Death Hospital, Institution or
Z City, Town or Village Milton Street Address Gateway House of Peace _
0 Manner of Death® Natural Cause 0 Accident ❑Homicide E Suicide ❑Undetermined 7 Pending
Circumstances Investigation
tu Medical Certifier Name Title
P. Kenneth Schwartz MD
iiig Address
377 Church St, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
City, Town or Village Milton L. Sb I ®'g
(Burial Date Cemetery or Crematory
02 / 01 / 2018 Pine View Crematory
®Entombment Address
<± Cremation Queensbury, NY
Date Place Removed
❑Removal and/or Held
and/or Address
go Hold
Date Point of
Q Transportation Shipment
LS by Common Destination
Carrier
igii
Q Disinterment Date Cemetery Address
0 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
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
CC
ILI
:. Permission is hereby granted to dispose of the human re ' s describe ove as indica d.
Date Issued I 13 I I1 0 Registrar of Vital Statisti
( gn e
District Number y Place Milton , 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 J Z Ili Place of Disposition l I'm V , l r,n.c __.
(address)
tii
1e (section) A (Jot number}- (grave number)
0 666 J\
0 Name of Sexton or Person in Charge of Pr mises r, a,.,itt
(pl ase print) •
. Signature 1"/ Title AVM
(over)
DOH-1555 (02/2004)