Young, Noreen 4, Li.
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Noreen K. Young Female
Date of Death Age If Veteran of U.S. Armed Forces,
03/23/2017 77 years War or Dates
Place of Death Hospital, Institution or
City, To9MXIKVXIMEXX Saratoga Springs Street Address Saratoga Hospital
0 Manner of Death El atural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
W. Circumstances Investigation
tu Medical Certifier Name Title
Jennifer L. White DO
Address
211 Church Street, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
City, TAKADNXDOWX Saratoga Springs 4501 149
gii ❑Burial Date Cemetery or Crematory
❑Entombment 03/24/2017 Pineview Crematory
Address
Uremation Queensbury, N Y
Date Place Removed
Z❑Removal and/or Held
2 and/or Address
F-" Hold
0 Date Point of
ti)Q Transportation Shipment
0 by Common Destination
Carrier
El Disinterment Date Cemetery Address
El Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Densmore Funeral Home 00448
Ri Address
7 Sherman Ave, Corinth, New York 12822
NO Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2 Address
Ill
t3 Permission is hereby granted to dispose of the human remains de ri d aber es ndicate
�
<> Date Issued 03/23/2017 Registrar of Vital Statistics �
(signature)
<:i District Number 4501 Place Saratoga Springs
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition yz.,.///7 Place of Disposition I/ Sj1, ) 6fi✓ 6- y
2 (address)
at
CC (section) r /dot number) (grave number)
CI Name of Sexton ers n in Charge of Premises `-)U-/r a'✓7 `14, a- /'
2 (ple/-
ase print)
W.
Signature Title C. '-2-fr I�
(over)
DOH-1555 (02/2004)