Mattison, Linda •
.. , ii g-n NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Linda Marie Mattison Female
Date of Death Age If Veteran of U.S. Armed Forces,
44
10/26/2018 69 Years War or Dates
Place of Death Hospital, Institution or
' City, Town or Village Saratoga Springs - Street Address Saratoga Hospital
Manner of Death Undetermined Pending
Q Natural Cause El ❑Homicide ['Suicide ❑ ❑
Circumstances Investigation_
Medical Certifier Name Title
Todd Duthaler DO
Address
44 211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City, Town or Village Saratoga Springs 4501 563
El Burial Date Cemetery or Crematory
10/29/2018 Pine View Crematory
❑Entombment Address
®Cremation Queensbury Town, New York
Date Place Removed
ri Removal
and/or and/or Held
4. Address
Hold
6 Date Point of
❑Transportation Shipment
by Common Destination
Carrier
❑Disinterment Date Cemetery Address
.04❑Reinterment Date Cemetery Address
4 Permit Issued to Registration Number
Al Name of Funeral Home Maynard D Baker Funeral Home 01130
it Address
11 Lafayette St,Queensbury,New York 12804
• Name of Funeral Firm Making Disposition or to Whom
: Remains are Shipped, If Other than Above
Address
T"
• Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/29/2018 Registrar of Vital Statistics ,yohn cP Franck(E(ectronicaffySigned)
(signature)
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:
mot= Date of Disposition /b I31 II:I Place of Disposition {;as ••s-/ (� Ur-t4--
(address)
(section) (lot numb (grave number)
• Name of Sexton or Person in Charge of Premises i I NilloiviS e,A1 K
� (please print)
0 Signature Title ark IPtit2
(over)
DOH-1555 (02/2004)