Tortora, Leona NEW YORK STATE DEPARTMENT OF HEALTH /'o
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Leona Joyce Tortora Female
Date of Death Age If Veteran of U.S. Armed Forces,
02 / 04 / 2017 77 War or Dates N/A
}- Place of Death Hospital, Institution or
21 City, Town or Village Saratoga Springs Street Address 9 Bensonhurst Ave.
0 Manner of Death®Natural Cause CI Accident D Homicide 0 Suicide � Undetermined �Pending
W. Circumstances Investigation
ILI Medical Certifier Name ______ Title
44 )c k c '- 0 4-Y1()c)-4- iY\6
Address
3 C G_ LLr t- Suti - 30D, Sagaitqa Sp, .NY id8b(L
Death Certificate Filed District Number y50 , Register Number
City, Town or Village Saratoga Springs
0Burial Date Cemetery or Crematory
02 / 07 / 2017 Pine View Crematory
0 Entombment Address
Cremation Queensbury, NY
Date Place Removed
Z❑Removal and/or Held
and/or Address
Hold
fa.
Date Point of
Q Transportation Shipment
by Common Destination
a Carrier
>< Disinterment Date Cemetery Address
No
Q Reinterment Date Cemetery Address
Permit Issued to ! Registration Number
iMi Name of Funeral Home Compassionate Funeral Care 00364
Address
> 1 402 Maple Ave., Saratoga Sp., NY 12866
>>«) Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2 Address
!:
ILI
CL
Permission is hereby granted to dispose of the human remain escr a bover ' icated.
MiiDate Issued 2,� �1�' Registrar of Vital Statistics t
ni
4.5b1 (signature)
iMil District Number Place Saratoga Springs , New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
at Date of Disposition Limn Place of Disposition ,6o0,....., (rrfiglvrsi.„,
12.
(address)
0
:f (section) , (lot number) (grave number)
aName of Sexton or Person in Charge of Premises C ��'� � "+��
z (pl se print) •
41 Signature A % Title i `
•
(over)
DOH-1555 (02/2004)