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Winslow, Joseph NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Perhhit Name First Middle Last Sex Joseph E Winslow Male Date of Death Age If Veteran of U.S. Armed Forces, 07/11/2017 53 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 0 Accident 0 Homicide Suicide El Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title Derek Smith MD Address 211 Church St,Saratoga Springs,New York 12866 • Death Certificate Filed District Number Register Number City, Town or Village Saratoga Springs 4501 336 0Burial Date Cemetery or Crematory 07/17/2017 Pine View Crematory • DEntombment Address '®Cremation Queensbury Town, New York sil Date Place Removed ❑Removal and/or Held and/or Address Hold Date Point of Q Transportation Shipment by Common Destination Carrier Date Cemetery Address Disinterment lc 11Reinterment Date Cemetery Address • Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 Address 24 Church Stpo Box 500,Lake Luzerne,New York 12846 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is hereby granted to dispose of the human remains described above as indicated. • Date Issued 07/12/2017 Registrar of Vital Statistics JohncPFranck E(ectronicallySigned (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: p Date of Disposition -�) 1 i Place of Disposition �?.�UieU C+wnpltos;,,� (address) (section) /}(lot number) (` (grave number) • Name of Sexton or Person in Charge of Premi s l�r=gti J to4�' (ple se print) Signature Title 4301104 (over) DOH-1555 (02/2004)