Sodemann, Toni 5.7J
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Toni L. Sodemann Female
Date of Death Age If Veteran of U.S. Armed Forces,
07 / 23 / 2017 61 War or Dates N/A
} Place of Death Hospital, Institution or
ZCity, Town or Village Saratoga Springs Street Address 199 Pyramid Pines Sat.
ck Manner of Death®Natural Cause 0 Accident Homicide E Suicide �Undetermined �Pending
Circumstances Investigation
tii Medical Certifier Name Title
C. Daniel J. Kuhn Coroner
Address
40 McMaster St., Ballston Spa. , NY 12020
Death Certificate Filed District Number Register Nujriber
City,Town or Village Saratoga Springs SI,5-`-'I 3 /
❑Burial Date Cemetery or Crematory
07 / 26 / 2017 Pine View Crematory
Entombment Address
ECremation Queensbury, NY
Date Place Removed
❑Removal and/or Held
rn and/or Address
0
Hold
Date Point of
Q Transportation Shipment
a by Common Destination
Carrier
ni
Q Disinterment Date Cemetery Address
:IRQ Reinterment Date Cemetery Address
11 Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care 00364
Address
3 402 Maple Ave., Saratoga Sp. , NY 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
l
Ut
44
Permission is he eby anted to dispose of the human remains decri d ove� cated.
F.
Date Issued • Registrar of Vital Statistics
(signature)
District Number LI 50‘ Place Saratoga Springs , New York
liii
:<; I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I
p 7/2l Place of Disposition
l� Date of Disposition � 17 p f�e(l 1� ��y,-�-��
2 (address)
w
LC (section) (1 t number) (grave number)
aName of Sexton or P son . Charge of Premises - _3.�- It444 &Q-►'K4
(please print) •
1 Signature Title L rtm ,4�
(over)
DOH-1555 (02/2004)