McHugh, Donald NEW YORK STATE DEPARTMENT OF HEALTH rVital Records Section Burial - Transitmit
Name First Middle Last Sex
Donald F.McHugh Male
Date of Death Age If Veteran of U.S. Armed Forces,
• 02/01/2018 86 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 a Natural Cause ❑Accident ❑Homicide Suicidett
to
Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
Eric Santell NP
Address
131 Lawrence St,Saratoga Springs,New York 12866
i. Death Certificate Filed District Number Register Number
City, Town or Village Saratoga Springs 4501 81
0 Burial Date Cemetery or Crematory
02/02/2018 Pine View Crematory
El Entombment Address
®Cremation Queensbury Town, New York
Date Place Removed
❑Removal and/or Held
and/or
Address
Hold
Date Point of
Transportation Shipment
by Common Destination
Carrier
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 Other than Above
Address
fee
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/02/2018 Registrar of Vital Statistics John PEranck(ECectronicafySigned)
(signature)
District Number Place SaratogaSprings,4501 Sprin New York
Lzio
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 21 S((V Place of Disposition ��, ,,,
(address)
(P.
a (section) (lot numbp (grave number)
, , L
Name of Sexton or Person in Charge of Pr ises z �.
( ease print)
Signature Title riW e,
(over)
DOH-1555 (02/2004)