Parker, Gladys .,- . v 137g
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Gladys Parker Female
gi Date of Death Age If Veteran of U.S. Armed Forces,
05 / 08 / 2018 83 War or Dates N/A
14 Place of Death Hospital, Institution or
City, Town or Village Albany Street Address Albany Medical Center
Uj
a Manner of Death Zr Natural Cause ❑Accident E Homicide 0 Suicide ❑Undetermined 0 Pending
3u Circumstances Investigation
ui Medical Certifier Name Title
Q James Wyant MD
Address
43 New Scotland Ave., Albany, NY
Death Certificate Filed District Number Register Number
City, Town or Village Albany 10 y y
iiiii C]Burial Date Cemetery or Crematory
05 / 09 / 2018 Pine View Crematory
`;:: Entombment Address
Cremation Queensbury, NY
`" Date Place Removed
Removal and/or Held
and/or Address
-, Hold
Cl)
0 Date Point of
Q Transportation Shipment
0 by Common Destination
Carrier
::`3 Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
in: Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care i 00364
iiiii< Address
'3 402 Maple Ave., Saratoga Sp., NY 12866
Mi
Name of Funeral Firm Making Disposition or to Whom
.14 Remains are Shipped, If Other than Above
2 Address
5
a" Permission is hereby granted to dispose of the human remains desc ' ed above as indicated.
Date Issued 05/09120/$Registrar of Vital Statistics Cry J
iiilig (signature)
District Number 0)D / Place C 0 .�
) Al any New York
I certify that the remains of the decedent iden • ied above were disposed of in accordance with this permit on:
Z
ill Date of Disposition 5Iti III Place of Disposition ,,.it-) j,...1.e...,
(address)
tti
IE (section) A (lot number) (grave number)
pName of Sexton or Person in Charge of Premises . 3 Itt
z ease print) •
i Signature s t- Title (l2E,1 ATOt
(over)
DOH-1555 (02/2004)