Bennett, Joanne U I
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle Last Sex
Joanne Bennett Female
• Date of Death Age If Veteran of U.S. Armed Forces,
01/18/2018 77 Years War or Dates
/ Place of Death Hospital, Institution or
City, Town or Village Saratoga Springs Street Address Saratoga Hospital
Manner of Death X❑ Natural Cause ❑Accident ❑Homicide ❑Suicide ❑ Undetermined El Pending
Circumstances Investigation
Medical Certifier Name Title
Catherine Dawson MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City, Town or Village Saratoga Springs 4501 50
❑Burial
Date Cemetery or Crematory
01/22/2018 Pine View Crematory
['Entombment
Address
®Cremation Queensbury Town, New York
Date Place Removed
Removal I and/or Held
and/or
Address
Hold
Date Foint of
Q 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
a •
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/22/2018 Registrar of Vital Statistics John c'Franck(E(ectronica((y Signed)
(signature)
District Number 4501 Place Saratoga Springs, New York
r '
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition lIf Place of Disposition k...;ior
(address)
(section) /� (lot number) (grave number)
Name of Sexton or Person in Charge of remises / • t— .-.41-
please p t)
Signature G✓' V C Title II t
(over)
DOH-1555 (02/2004)