Allison, Dorothy NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Dorothy Allison Female
. Date of Death Age If Veteran of U.S. Armed Forces,
04/12/2018 81 Years War or Dates
4.- - Place of Death Hospital, Institution or
City, Town or Village Albany Street Address St Peters Hospital
Manner of Death Eie Natural Cause 0 Accident 0 Homicide 0 Suicide ni Undetermined El Pending
Circumstances Investigation
W Medical Certifier Name Title
d Brittany Quinn NP
Address
315 S Manning Blvd,Albany,New York 12208
Death Certificate Filed District Number Register Number
77 City, Town or Village Albany 0101 0824
❑Burial Date Cemetery or Crematory
04/16/2018 Pine View Crematory
❑Entombment Address
m. ®Cremation Queensbury Town, New York
Date Place Removed
Z❑Removal and/or Held
d and/or Address
NHold
0 Date Point of
pi ❑Transportation Shipment
0 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
XRemains are Shipped, If Other than Above
Address
X
W
4' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/13/2018 Registrar of Vital Statistics Danielle S Gillespie(Electronically Signed)
(signature)
District Number 0101 Place Albany, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition `I)11 I l4 Place of Disposition F,it/,,, (Lir—
(address)
5
az (section) lot number) (grave number)
0 Name of Sexton or Person in Charge of Premises (Ir.) St--.�
(p/e se print)
,• Signature `J s Title AVM nit t
(over)
DOH-1555 (02/2004)