Loading...
Cordiale, Helen NEW YORK STATE DEPARTMENT OF.HEALTH # 3 1b • Vital Records Section Burial - Transit Permit • Name First Middle Last Sex Helen I Cordiale Female gt Date of Death Age If Veteran of U.S.Armed Forces, 05/15/2018 55 Years War or Dates Place of Death Hospital, Institution or City, Town or Village Saratoga Springs Street Address Saratoga Hospital Manner of Death©Natural Cause ❑Accident ❑Homicide ❑Suicide ri"—I Undetermined ❑Pending _, Circumstances Investigation M• edical Certifier Name Title Carlos Ares MD Address r3 211 Church St,Saratoga Springs,New York 12866 D• eath Certificate Filed District Number Register Number City, Town or Village Saratoga Springs 4501 280 Date Cemetery or Crematory • ❑Burial 05/17/2018 Pine View Crematory • ❑Entombment Address ®Cremation Queensbury, New York iti Date Place Removed • Removal and/or Held _- and/or Address Hold s ` Date Point of - ❑Transportation Shipment by Common Destination Carrier Disinterment Date Cemetery Address ig LiQ Reinterment Date Cemetery Address Permit Issued to Registration Number -.• Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom Y Remains are Shipped, If Other than Above 7 A• ddress • Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/17/2018 Registrar of Vital Statistics JohncPPranck(ECectronica1ySigned) (signature) `` District Number Place 4501 Saratoga Springs, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ""`, Date of Disposition 51I$I li Place of Disposition x.iL, (-46-1 fix=; (address) (section) � of number) (grave number) SD J Name of Sexton or Person in Charge of Premises ` h t - (plese print) d Z Signature Title ro 4114x (over) DOH-1555 (02/2004)